Dealing With Vaginal Rips and Tears After Sex

In general, your vagina is elastic and resistant to tears. But under certain circumstances, sex can tear the vaginal skin.

“Most tears are mild and heal quickly on their own,” says Ob/Gyn Salena Zanotti, MD. “If the tear is significant or you have an underlying medical condition, you may need to see a healthcare provider.”

Dr. Zanotti explains the different types of vaginal tears, why they happen and what you can do to prevent them.

What are vaginal tears during sex?

Vaginal tears are breaks in the skin caused by sexual intercourse. They can occur:

• At the opening of the vagina (introitus). These tears tend to be mild, shallow cuts that don’t bleed much. They may feel sore or burn when you pee. You may also see a tinge of pink when you wipe that area.
• Inside the vagina. These tend to be larger tears. Because the tissue in the vagina has many blood vessels, they may bleed more.

Why do vaginal tears happen?

There are many causes of vaginal tears during sex. For example, some medications and health conditions can make the skin in and around your vagina more prone to tearing:

• Menopause. Sex is often different after menopause. Your estrogen levels drop, causing vaginal tissue to become thin and dry. For some people, regular intercourse can tear the skin inside the vagina.
• Radiation therapy. Radiation therapy for cancer in the pelvic area can weaken skin and increase the risk of a tear.

Tearing can also be due to sex-related factors, such as:

• Penis size. A large penis can stretch the opening of your vagina, causing small tears.
• Sex practices. Sex toys, genital piercings and rough sex can disturb the skin in and around your vagina.
• Sex too soon after childbirth. If you had a vaginal tear after birth, sex can reopen that tear. After giving birth, wait at least six weeks before having sex to allow a tear to heal. You may need longer if you have a deeper tear.
• Virginity. Your hymen may break and bleed the first time you have sex, although this doesn’t always happen.

“If you’re having pain or tears during sex, let your partner know,” advises Dr. Zanotti. “Communication is important for developing safe sex practices and healthy relationships.”

Consent — your verbal OK for sex — is also essential. If you or someone you know has been sexually assaulted, call 911 or seek medical care immediately. You can also reach out to the National Sexual Assault Hotline (1.800.656.4673) at any time.

How to heal vaginal tears after sex

Most vaginal tears get better on their own within a day or two. If it’s a deep tear, you may need stitches, antibiotics and extra time to recover.

To help a tear heal, Dr. Zanotti recommends the following steps:

• Avoid sex until you’re fully healed.
• Avoid panty liners if the tear is outside of your vagina or tampons if it’s inside your vagina.
• Keep the area clean and dry.
• Refrain from using scented soaps that might irritate your skin.
• Take an over-the-counter pain reliever if you need it.
• Use an over-the-counter corticosteroid cream to ease irritation and inflammation.
• Wear cotton underwear and relaxed clothes (or don’t wear any underwear).

When to call your healthcare provider about vaginal tears

Mild tears typically don’t require a medical evaluation. Let your provider know if you have:

• Bleeding after sex
• Frequent tears
• Signs of infection, such as pain, redness, pus, bad odor or fever
• Symptoms that aren’t getting better after one week

How to prevent tears during sex

Prevention strategies depend on what’s causing the vaginal tears. Some possible options include:

• Lubricant. If thin vaginal skin or vaginal dryness is an issue, a water-based or silicone-based lubricant can help. Avoid warming lubricants or those with perfume, which can irritate the skin. For a natural alternative, try olive or coconut oil.
• Vaginal dilation. Dilation is the process of stretching the skin around your vaginal opening. This method can help if you have pain during sex or a larger partner. For at-home treatment, use your fingers to expand the tissue. Or talk to your provider about vaginal dilator therapy.
• Vaginal estrogen. Vaginal estrogen is a form of hormone replacement therapy that involves placing cream or a ring inside your vagina. The hormone helps improve the natural thickness and lubrication of the skin.

And don’t forget about annual checkups to keep your vagina healthy. Routine Pap tests and pelvic exams can help detect cancer and other problems early. These checkups are also a good time to bring up any ongoing issues, like vaginal tears.

“Some people find it difficult to talk about certain issues,” recognizes Dr. Zanotti. “Your provider is there to listen and help — without judgment. An open and honest approach can help you find a solution to help you enjoy sex more.”