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Published on: 3/17/2025

What Are the Common Causes of Perineal Pain, and How Can It Be Managed Effectively?

Perineal pain is often caused by childbirth-related tears or an episiotomy, and it can be managed with pain medications like NSAIDs, cold packs, sitz baths, and proper rest.

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Explanation

Perineal pain is common after giving birth because the area between the vagina and the anus can be injured during delivery. Two common causes are perineal tears and an episiotomy, which is a small cut made by a doctor to help the baby come out. These injuries can lead to pain, swelling, and discomfort after delivery. Other causes might include infections in the area or healing after perineorrhaphy, a surgical repair of the perineum. To help manage the pain, doctors may recommend pain relievers such as non-steroidal anti-inflammatory drugs (NSAIDs) taken by mouth or used as a rectal suppository, which have shown good results for easing discomfort in the early postpartum period. In addition, using cold packs on the area, taking warm sitz baths to soothe the skin, and getting plenty of rest can be very helpful. Always follow your healthcare provider’s advice and let them know if the pain gets worse or if you notice signs of infection. This way, you can get help to feel more comfortable as you recover.

(References)

  • Luxey X, Lemoine A, Dewinter G, Joshi GP, Le Ray C, Raeder J, Van de Velde M, Bonnet MP; PROSPECT Working Group of the European Society of Regional Anesthesia and Pain Therapy. Acute pain management after vaginal delivery with perineal tears or episiotomy. Reg Anesth Pain Med. 2024 Jun 14:rapm-2024-105478. doi: 10.1136/rapm-2024-105478. Epub ahead of print. PMID: 38772634.

  • Wuytack F, Smith V, Cleary BJ. Oral non-steroidal anti-inflammatory drugs (single dose) for perineal pain in the early postpartum period. Cochrane Database Syst Rev. 2021 Jan 11;1(1):CD011352. doi: 10.1002/14651858.CD011352.pub3. PMID: 33427305; PMCID: PMC8092572.

  • Achariyapota V, Titapant V. Relieving perineal pain after perineorrhaphy by diclofenac rectal suppositories: a randomized double-blinded placebo controlled trial. J Med Assoc Thai. 2008 Jun;91(6):799-804. PMID: 18697376.

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