What Is Perineal Pain (Perineum Pain)?
The perineum is the area located between the anus and the scrotum in men and between the anus and the vagina in women. The major muscles of the pelvic floor all attach to the perineum and it is one of the most common areas of pain in men and women who suffer from various forms of pelvic pain. In men, the pain may be located in the perineum but may also radiate to the testes and the rectum. It’s important to note that in men, pain in the perineum has very different causes than in women.
The causes of perineal pain are varied, but fall into a few different categories:
Duct obstruction, entrapment of pudendal nerve, abscess, prostatitis, perineural cyst, ischiorectal abscess, benign prostatic hypertrophy, and prostatitis
Colitis, appendicitis, and proctitis
Typical symptoms include one or more of the following:
- Genital pain, anal and rectal pain, suprapubic pain, pain in bladder area, tailbone pain, groin pain, low back pain
- Discomfort when sitting (many say that it feels like they are sitting on a golf ball), pain after bowel movements
- Urinary frequency, urgency, hesitancy, burning, frequent nighttime urination
- Sexual pain including orgasm and post orgasm discomfort (can even be the next day)
Diagnostic workup to identify the cause of perineal pain starts with a conversation regarding your recent medical history. The discussion is usually followed by a physical exam, which will determine the amount of pain you are in and if there is anything in the area directly causing the pain. Other tests used in diagnosing the cause of perineal pain include:
- Blood tests
- Radiological evaluation or ultrasound
Treatment of perineal pain in men can be challenging. A thorough evaluation is necessary to determine the most likely cause of perineal pain. This then guides the treatment decision in order to treat the underlying cause of perineal pain. Common treatment for perineal pain or perineum pain is bed rest which will help relax the perineal area. If it’s simply stretched or bruised, bed rest will allow the area to repair itself. Other treatment options that can help include perineal massage and antibiotic treatment.