I am 33 male and have this same problem swollen perineal, it always happens after having multiple bowel movements especially if you have diahrhea Spelled wrong dont care ;) It seems to be caused by excessive wiping and once becomes irritated can spot toilet paper with blood. I try to wipe lightly and be careful of the area but the best cure i have found is to take hot baths. I usually never take baths but when this problem arises i usually take warm baths for the next few nights its like magic if you let the area soak the irritation goes away and the swelling will decrease each day.. Dont know why i have the problem now, never used to but now i deal with it a few times per month but the bath and soaking is a sure shot way to reduce the effects.