Ongoing Perineal Tear: Seeking Solutions
I’m a 21-year-old woman dealing with a problematic perineal tear that has persisted for over six months. This injury tends to heal but then reopens for reasons that remain a mystery to me. Even slight movements, like gently spreading my legs, have resulted in new tears. Lately, the bleeding has been continuous for more than three days, and it shows no signs of healing. I haven’t participated in any activities in months due to this issue, so I’m certain that’s not contributing to the problem. The pain is nearly constant, intensifying when I sit on the toilet, and it bleeds profusely. At one point, I even mistook the bleeding for my menstrual period, even though I’ve been on birth control to skip those cycles. My gynecologist suggested using a menopause-related cream to boost estrogen levels in that area, but unfortunately, my insurance won’t cover it, leaving me feeling quite lost. Has anyone encountered a similar situation or knows the underlying causes of this tear so I can find an effective treatment? I’m considering a visit to urgent care to investigate the swollen condition and continuous bleeding, as I fear it might be infected. After that, where should I turn for help? Here’s a rundown of my current medications: - Thyroxine - Bentyl - Spironolactone (recently started) - Acid reflux medication - Vitamin D supplement - Iron - B-complex vitamins - Pristiq - Enskyce (birth control) Additionally, I live with the following health conditions: - Hashimoto’s thyroiditis - IBS-D (diagnosed approximately a month ago, with symptoms lasting around six months) - Acid reflux I hope to hear from others who might have dealt with this before or have insights on how to move forward.
Answers (1)
8/7/2025, 7:50:51 PM
OpenHealth AI
I'm really sorry to hear that you’re going through such a distressing and persistent issue. It sounds quite challenging and painful. Given that you've had a perineal tear for over six months with continuous bleeding and pain, here are some main points and recommendations to help you find relief and clarity on your situation.
Main Points:
- Continuous Bleeding is Concerning: The ongoing bleeding for more than three days and the reopening of the tear are concerning and may indicate an infection or other underlying issue.
- Potential Response to Hormonal Changes: Hormonal factors, particularly estrogen, can significantly affect healing in the vaginal area. Your gynecologist's suggestion to use estrogen cream indicates that this might play a role.
- Next Steps for Care: Immediate evaluation is necessary due to the continuous bleeding and pain. It's critical to ensure there’s no infection or other complications.
Explanation:
Perineal tears can result from childbirth, but they can also happen due to other reasons, like persistent irritation, hormonal imbalances, or muscle tension. Your situation is influenced by several factors, including your thyroid condition, IBS, and likely hormonal changes, particularly since you're finding the tear reopens with minimal movement. The use of medications and hormonal changes might also play a role in how well your tissue heals.
Suggested Actions:
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Seek Immediate Care: Since you’ve mentioned bleeding for more than three days, I strongly recommend that you visit urgent care or an emergency room. They can assess if there is an infection or any other complications needing urgent attention.
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Discuss Hormonal Treatment Options: If the urgent care doesn’t address your concerns about the estrogen cream due to cost, please ask about alternative treatments that could boost healing, such as over-the-counter hydrating vaginal gel, or explore patient assistance programs with your doctor.
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Track Symptoms: Keep a record of your symptoms, including when the bleeding occurs, any activities that cause pain, and all medications you are taking. This information will be very helpful for healthcare providers in determining the best treatment.
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Follow Up: After urgent care, consider making a follow-up appointment with a gynecologist or a specialist in pelvic floor disorders. They can provide more insight into why the tear keeps reopening and discuss tailored therapies or interventions.
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Self-Care Techniques: While preparing for medical visits, focus on gentle self-care. Consider using sitz baths to soothe the area, and ensure you maintain a high-fiber diet to avoid straining during bowel movements, especially with IBS.
It's understandable to feel overwhelmed, but you're taking the right steps by seeking help. Please take care, and best of luck on your path to healing. If you have any other questions or need more information, feel free to ask!
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