Vaginal tears causes, symptoms, treatment—and when to see your doctor

Prevention is better than cure when it comes to vaginal tears, our experts share their top advice

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Vaginal tears are very common and not just as a result of childbirth. Here we share the top causes and best treatments for vaginal tears—and how to prevent them, according to the experts.

There's a common misconception that vaginal tears only happen as a result of childbirth, In reality, tears can be caused by a range of factors, from sex to inserting or removing tampons incorrectly to yeast infections. “The most common cause of vaginal micro-tears is some form of abrasion—the ones that we often see in clinics are usually associated with inappropriate use of sanitary wear, particularly tampons," says gynecologist Anne Henderson, who works with Canesten.

The good news is, smaller tears are usually harmless and will often go unnoticed. And there are steps you can take to prevent vaginal tears altogether. When it comes to childbirth, doing plenty of kegel exercises can really help strengthen your pelvic floor muscles and may reduce the risk of severe tearing. While using more lubrication during sex and choosing sanitary products to suit your flow can do wonders to keep your vagina healthy and happy. The key thing to remember is that prevention is easier than a cure for vaginal tears, as treatment options are fairly limited. 

What are vaginal tears?

“Vaginal tears or micro-tears are usually tiny tears that can occur in the tissue within the vagina or on/within the tissue around the vulva—near the entrance to the vagina,” says Anne. “Micro-tears usually aren’t identifiable to the naked eye. They’re unlikely to cause pain or bleeding, so for the most part they’re asymptomatic and people may not know that they have them."

However, it's important to know how to spot them, as they can lead to a source of infection getting into the body and into the bloodstream. 

How to spot vaginal tears

  • Mild pain
  • Stinging when passing urine
  • Discomfort when inserting a tampon
  • Pain during sex
  • Bleeding or spotting 
  • Itching, burning, or a tearing sensation
  • Unusual discharge 

What causes vaginal tears?

"Vaginal tears are most commonly linked to childbirth, and can range from small grazes (first degree) within the vaginal canal to extensive tears from the vagina to your rectum (fourth degree)," says Dr Shree Datta, gynecologist for intimate wellbeing brand INTIMINA. 

Each vagina is unique and tears can form as a result of a variety of factors, including sex, inserting tampons, using menstrual cups, and health conditions like vaginal dryness.

"Smaller tears can also occur during sex, incorrect insertion or removal of tampons or menstrual cups or with vaginal dryness. This is a common vagina problem and can often be seen at the time of menopause. They can cause a sore vagina, irritation, or bleeding."

The main causes of vaginal tears are:

1. Tampons

“If you use a higher absorbency tampon than you need, this can cause micro-tears in the vagina," says Anne. This is because the more absorbent the tampon is, the more bacteria it can hold onto. If you do have a heavy flow, you can speak to your medical provider about how to best manage this, or use a lighter absorbency tampon and a pad for added protection and comfort.

"Removing a tampon when it’s not fully absorbed can also cause vaginal tears due to friction," adds Anne. As a result of this, the staphylococcus (staph) bacteria may be able to get through the skin and into the bloodstream. 

Staph bacteria live harmlessly on our skin, often in our nose, armpits, and buttocks. However, it only causes infection if it gets into our skin through a cut. This is what can potentially cause toxic shock syndrome (TSS). This is when the bacteria releases harmful toxins inside our body. It can get worse rapidly and become fatal if not treated efficiently. If you think you might have TSS, seek medical advice urgently.

Symptoms of TSS include:

  • High temperature
  • Flu-like symptoms—such as feeling cold, a headache and sore throat.
  • Feeling and being sick
  • Diarrhoea

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2. Menstrual cups

Although they're great for the environment, menstrual cups may cause vaginal tears in some circumstances or if used incorrectly. “While less likely when using other forms of sanitary wear, the trend for menstrual cups can present potential problems," says Anne. "If you struggle with inserting and removing the cup, you may be at risk of creating micro-tears too. However, if inserted and removed correctly, you shouldn’t have a problem.”

Avoid problems by making sure you pick the best menstrual cups to suit your flow and body shape. It's also worth making sure you know how to use a menstrual cup correctly before you insert it. If you don't feel comfortable using menstrual cups but still want an economical product, shop for the best period underwear instead. This will completely reduce your risk of needing vaginal tear treatment as a result of sanitary wear. 

3. Sex

Experiencing a vaginal tear after sex can happen, and may lead to you needing vaginal tear treatment. "Having sex with a new partner or in a different position can lead to tears as the skin around your vagina is delicate," says Dr Datta. "It can tear easily with forced penetration, particularly without adequate foreplay or lubrication." 

Choosing the best sex positions for you (and investing in the best lube) can help reduce pain during sex and the risk of vaginal tears. Talking to a medical professional can also be helpful. "If this happens repeatedly, speak to your doctor as it can affect your ability to have sex and to enjoy it," advises Dr Datta.

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4. Yeast infection

“Another potential cause of vaginal micro-tears is a complicated yeast infection (thrush), which may occur as a result of ineffective treatment, or treatment not taken soon enough," says Anne. “The swelling and itching that occur in the vagina due to a complicated yeast infection can cause vaginal tears and sores within the tissue, so it’s important to seek advice and treatment as soon as possible. Discover what causes thrush for you and how to avoid it. As if you experience recurrent thrush infections, the regular symptoms may also put you at risk of micro-tears.”

For this condition, prevention is always better than cure. "I strongly recommend regular use of a good quality probiotic if you're experiencing recurrent thrush, which will help increase the presence of lactobacillus in the vaginal area," says Anne.

5. Vaginal dryness

"When women enter menopause, their bodies may experience a whole host of changes. These include changes to the vaginal skin, which is predominantly caused by a reduction in estrogen, as the ovaries wind down," says Dr Shree. 

This can cause vaginal dryness, making the skin more prone to bleeding and small tears that can be very painful. Investing in some vaginal dryness treatments could help. "If untreated, sex may become more difficult and it can be painful to have a pap smear," says Dr Shree (although tears will not show up on your pap smear results).  

Vaginal tear prevention

Vaginal tear treatment options are quite limited, which is why prevention is always recommended. 

Vaginal tear prevention advice, according to our experts:

  1. Selecting the correct tampon absorbency—“There is a strong argument to say you should use the lightest absorbency tampon that you need and change it as frequently as you can. If you are concerned about your flow changing or being unpredictable, you could use a pad as a backup," Anne says.
  2. Using lube during sex to ease friction—Use plenty of lube and avoid positions or sex toys that feel uncomfortable. If you do have an intimate infection, such as thrush, seek medical advice and diagnosis as soon as you start to experience symptoms. "This can help reduce the risk of a more complicated infection and reduce the risk of vaginal micro-tears," explains Anne.
  3. Eating the right foods—opt for foods for a healthy vagina to promote a healthy vaginal microbiome. Add foods like cranberries, leafy greens, avocados, and oily fish to your diet.

When to see a doctor about vaginal tears

Because micro-tears are usually symptom-free until something more serious, such as an infection arises, you might be unaware that you have a problem.

“The time to see a doctor or a gynecologist is when you develop wider symptoms which may indicate a problem—this can be discomfort, irritant discharge, and pain," says Anne. 

However, you should visit a doctor when you notice any changes in your vaginal health that are unusual and cause discomfort. “Once you seek medical advice, you will need an internal examination to ensure everything is fine,” explains Anne.

With thanks to gynecologist and Canesten representative Anne Henderson, and Dr Shree Datta, gynecologist for intimate wellbeing brand INTIMINA.

Rose Goodman is a junior health writer and she writes across print titles and websites including woman&home.

Prior to pursuing her career as a writer, Rose obtained a degree in psychology and went on to work in adult mental health for five years, specifically working with people diagnosed with eating disorders, anxiety, depression and OCD. Mental health and wellbeing is something Rose feels incredibly passionate about and believes normalising the conversation around mental illness is something we should all actively strive to do.