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The perineum — the small stretch of skin and muscle between your anus and genitals — isn't a part of your anatomy you'd ordinarily think much about. If it's chronically sore, however, the perineum can really draw attention to itself! What can cause a sore perineum?

Causes Of Perineal Pain In Women

A current or recent pregnancy is one of the more common causes of perineum pain in women, something that should come as no surprise as a significant portion of the weight of a pregnant uterus falls on this area. During vaginal childbirth, the perineum is stretched and may tear or receive an episiotomy (surgical cut).

Outside of pregnancy, perineum pain in women may be caused by:

  • Vulvodynia, a vulvar pain disorder that may be diagnosed in the absence of other verifiable causes. 
  • A urinary tract infection
  • A pelvic floor disorder, which occurs if the muscles, ligaments, nerves, and connective tissues supporting your pelvic organs become weakened or damaged. Besides a feeling of painful pressure in the perineum, women with pelvic floor disorders can experience incontinence (urinary and fecal), muscle spasms, and feel a bulge. 
  • Neuropathic pain, caused by a disease of the somatosensory nervous system or physical damage. 
  • The pain can also be referred — you feel it in your perineum, but it originates elsewhere. 

Causes Of Perineal Pain In Men

Causes of perineum pain and soreness exclusive to men include:

  • Prostatitis, an inflammation of the prostate that can be bacterial or non-bacterial. Besides pain in the perineum, men who have it may experience painful ejaculation, pain while peeing, increased urinary frequency, and a weak urinary stream. Depending on the cause of prostatitis, fever is also possible. 
  • Other prostate-related conditions such as prostate stones and an enlarged prostate. 
  • Obstructed ejaculatory ducts. 

Men can likewise experience perineum pain due to pelvic floor dysfunction, referred pain, and neuropathic pain, just like women can. 

Causes Of Perineal Pain Possible In Men Or Women

Other conditions that can cause pain and discomfort in the perineum in people of both sexes are:

  • Perineal pain syndrome or idiopathic perineal pain — cause unknown, though research suggests it is often caused by an internal rectal prolapse. 
  • Interstitial cystitis, another condition of unknown cause that leads to symptoms similar to those of a UTI. 
  • Anal fissures (small tears in the anal mucosa), inflammation of the colon (colitis), or inflammation of the anus (proctitis). 

I Want To Get To The Bottom Of This, What Now?

The cause of perineum pain may be rather hard to determine, especially because the pain can be referred and caused by a problem outside of this immediate area — including, for instance, appendicitis. 

People experiencing perineal pain that doesn't have an obvious cause, such as pregnancy, being newly postpartum, or even having had especially vigorous sex, should see a doctor whether the pain is new or your problem has been ongoing for a while now. Proper diagnosis is the key to getting the treatment you need and ridding yourself of this literal pain in the behind. 

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