Perineum: Location, Anatomy, Function & Conditions (2025)

What are the common conditions and disorders that affect your perineum?

Childbirth is the most common cause of injury to your perineum. About 85% of people who give birth vaginally experience a torn perineum. Still, you can injure your perineum regardless of your sex.

Females

• Vaginal delivery: A baby making their way through your vagina (birth canal) can cause your vagina and your perineum to stretch and tear. Most tears are minor and heal in time. Depending on the tear, you may need stitches to repair the tissue. Major tears can damage your nearby pelvic floor muscles or anal sphincter. A torn perineum can make it difficult to pee, poop or have intercourse.
• Episiotomy: During this procedure, your provider cuts your perineum before delivery to make your vagina wider for childbirth. Episiotomies were once routine. They’re becoming rarer as increasing evidence suggests that episiotomies may increase the likelihood of pelvic pain and incontinence following delivery for some people.

Males

• Prostatitis (prostate inflammation): An infection or injury affecting your prostate can cause inflammation and pain that you feel in your genitals and perineum.
• Surgery: Your provider may have to cut your perineum to perform surgery on your prostate, to remove a tumor or to repair a urethral stricture (when the tube that carries pee out of your body is too narrow).

All sexes

• Pelvic floor dysfunction: Injury to your perineum increases the likelihood you’ll have trouble peeing or pooping.
• Perineal cysts or abscesses: You can get infected cysts or abscesses on your perineum or inside your anus. They’re often red, swollen and painful.
• Hemorrhoids: Hemorrhoids are swollen veins in your rectum or anus. They may be inside your body, or they may poke out of your anus. They may cause bleeding, itching or pain in your perineum. That pain may radiate to your rectum and get worse when you’re pooping or immediately afterward.
• Pudendal nerve entrapment: The pudendal nerve runs through your perineum. If it gets injured and inflamed, you may feel pain in your perineum that starts suddenly or gradually appears over several weeks or even months.
• Referred pain: A variety of conditions that begin in one part of your body can radiate pain to your perineum. Appendicitis, colitis and some gastrointestinal disorders can cause pain in your perineum.
• Fournier’s Gangrene: This is a rare bacterial infection and flesh-eating disease that causes the skin of your genitals and your perineum to die. It’s more common in males who are in their 50s and 60s and have diabetes.
• Injury or trauma: Injuries related to motorcycling, bike riding or horseback riding can damage your perineum. If you’re a cyclist, using a noseless bicycle seat can remove pressure from your perineum and reduce your risk of injury.
• Sexual abuse: A torn perineum may be a sign of sexual abuse or violence.

What are common signs or symptoms of a condition involving your perineum?

Pain is the most common sign that something’s wrong with your perineum. After childbirth, you may experience pain from a torn perineum that makes it difficult to walk or sit.

Other symptoms may signal an issue with your perineum or a condition affecting the surrounding muscles or organs in your pelvic cavity, including:

• Trouble peeing or pooping.
• Sore or itchy perineum.
• Difficulty getting an erection.
• Pain when you pee or have intercourse.
• A lump on your perineum, redness and swelling.

What are common tests to check the health of your perineum?

Your provider can check for an injury, infection or other condition that’s affecting your perineum by doing a physical exam. The exam may include a digital rectal exam, where your provider places a gloved finger into your rectum to feel for any irregularities.

Imaging procedures can help your provider diagnose problems affecting your perineum:

• CT Scan: Can show if there’s been an internal injury to your perineum.
• MRI: Can show if there’s been damage to the blood vessels or muscles in your perineum.
• Ultrasound: Can show damaged blood vessels in your perineum.
• X-Ray with dye: Can show any damage to your urethra (the tube that carries pee out of your body). Your urethra passes through tissue in your perineum.

What are common treatments for the perineum?

Your provider can assess any cuts or tears on your perineum to determine whether you need stitches to repair your injury. In the meantime, pain management strategies can ease your symptoms as you heal.

• Sitz bath and warm compresses: A sitz bath is a shallow, warm-water bath that cleans your perineum and aids in healing. You should use a sitz bath twice a day for at least five to ten minutes. Pat your perineum dry after leaving the bath instead of scrubbing.
• Pain medications and numbing sprays: Taking acetaminophen (Tylenol®) or ibuprofen (Advil®) and using pain-numbing sprays can ease the pain while your body heals. Hemorrhoid wipes and creams can help with pain, itching or burning in your perineum, too.
• Peri-bottle: A peri-bottle is a small container that you can fill with warm water and use to spray your perineum after going to the bathroom. It cleans you gently so that you don’t have to wipe with toilet paper.
• Constipation prevention: Straining through bowel movements may worsen perineum pain. Eating a high-fiber diet and drinking at least eight cups of water a day can help prevent constipation.
• Pelvic floor exercises (Kegel exercises): Strengthening your pelvic floor muscles after childbirth can help your body heal and rebuild after experiencing tears. Your healthcare provider may refer you to a physical therapist for specialized pelvic floor exercises. Only attempt Kegels following an injury with your provider’s guidance.

Your provider may prescribe antibiotics or incise (cut) and drain an infected cyst. You may need surgery if you have severe hemorrhoids or nerve damage in your perineum.