How to Avoid Vaginal Cuts
Although the term “vaginal cuts” may sound a little scary, they occur often in women who are sexually active. These small abrasions, cuts, and tears are usually not serious, but they can be uncomfortable and bothersome.
“Vaginal cuts are relatively common, even in women who don’t have any underlying abnormality,” says Grace Evins, MD, a gynecologist at Live Well in WNC in Asheville, North Carolina.
The most common cause of tiny vaginal tears or cuts (apart from childbirth) is penetration during sex, according to UW Medicine.
Fortunately, most vaginal cuts aren’t medically serious. If you know the cause and think it’s superficial, a visit to the doctor isn’t necessary, UW Medicine says. But that doesn’t mean you should dismiss them as no big deal. The discomfort caused by vaginal cuts can make sex unpleasant and can affect your overall quality of life.
The good news is that there are tools and strategies to help prevent cuts from happening in the first place. Read on to find out what the experts say.
What Causes Vaginal Cuts?
When you’re aroused, the vagina naturally produces fluids that lubricate the area during sexual activity, reducing friction that can irritate or tear the vaginal tissue. But many variables can affect how much lubrication your body produces. And if there isn’t enough natural moisture created, tearing can occur.
“Vaginal dryness is often part of the problem, because dryness creates friction, and that’s the main reason the tears and abrasions occur,” says Dr. Evins.
Other factors play a role in vaginal dryness.
Menopause “The vagina has natural defenses to reduce the chance of injury. In the presence of estrogen, which is much higher in premenopausal women, there are many factors that create an environment that’s more resilient and less vulnerable to damage to the superficial skin or vaginal mucosa,” Evins explains.
For starters, estrogen improves blood flow to the area, which helps keep the vagina moist, she says. The hormone also helps maintain the thickness of the vaginal lining and keeps the surrounding tissue flexible (also called elasticity).
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Post-menopausal women have lower levels of estrogen, which can cause thinning, drying, and inflammation of the vaginal walls, all of which make vaginal cuts more likely, says Evins.
Not enough foreplay Sexual excitement causes the secretion of vaginal fluids. If you skip foreplay or you don’t spend enough time getting turned on, your body doesn’t have a chance to create the natural lubrication that can make penetration more comfortable and less likely to result in tearing, according to UW Medicine.
History of abuse Although this is not the most common cause of vaginal dryness, a history of sexual abuse can affect a woman’s relationship to sex, according to the Sexual Medicine Society of North America.
“Abuse can disrupt the stages of sexual response in women, beginning with arousal and lubrication. Women who have fear around past experiences of painful rather than pleasurable encounters will have more dryness as a result,” says Evins.
Additionally, painful and traumatic experiences in the past during sex may cause a woman’s body to guard against future pain, she says.
“In anticipation of a repeat painful experience, women may involuntarily contract the powerful pelvic muscles narrowing the aperture of the vagina, creating greater friction with penetration. Another word for this involuntary muscle contraction is vaginismus,” says Evins.
Pelvic floor muscles “Tight or overactive pelvic floor muscles can cause decreased blood flow to the vagina and vulvar tissues. That impacts vagina tissue health, making it more likely to be thin and dry,” says Ashley Rawlins, PT, DPT, a doctor of physical therapy who specializes in pelvic and obstetric health at Origin Physical Therapy in Dallas.
Pelvic floor issues can also make penetration more difficult, says Dr. Rawlins. “If those pelvic floor muscles that surround the vaginal opening aren’t releasing, relaxing, and opening for penetration, it can put more stress on the tissue and leave you more at risk for injury,” she says.
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Other causes of vaginal cuts Sex toys are sometimes made of materials that are irritating to the skin, or they might have sharp or rough edges. Even a tampon that rubs against you the wrong way may cause tiny tears, says Rawlins.
How Can Vaginal Cuts Be Prevented?
Since vaginal dryness is often responsible, increasing wetness in the vagina during sexual activity is often the best way to go. The following are some ways to do this.
Lubricants
Lubricant, also called lube, is a very helpful tool with any sort of penetration, says Rawlins. “These products have come a long way. Gone are the days when there were just one or two options,” she says.
Water-based lubricants Water-based lubes are most common, says Rawlins. “You may have to do some label reading because there are some key differences between products,” she says.
Before buying, make sure the lube doesn’t contain irritating ingredients, such as paraffins, propylene glycol, glycerin, petroleum, or petroleum-based ingredients. “These can increase the risk for irritation, bacterial overgrowth, and even infection, which can further impair the skin’s health,” says Rawlins.
Rawlins also recommends avoiding lubes that have scents and tastes, or that “heat” things up. “These can irritate mucosal tissue, especially if it’s already dry or sensitive.”
Flavored lubes contain sugar and can cause yeast infections, according to the University of Texas in Austin’s University Health Services.
Natural oils Olive oil and coconut oil are natural, and some women really like them, says Rawlins. But oils can stain fabric and undermine the strength of condoms, increasing the risk of breakage, per UT Austin University Health Services.
Silicone-based lubricants “These lubes are very popular, in part because they tend to last longer than water-based lubricants,” says Rawlins.
If you’re using sex toys or vibrators made with silicone, be aware that silicone-based lubes can break down that material and cause tiny cracks in the devices, she says. “And that may cause bacterial growth which can then be transmitted to you or your partner when using it later,” says Rawlins.
Rawlins recommends trying different kinds of lubricants to find the one that suits you. “It is very individual. Don’t just take a friend’s recommendation, because what they like might not be what’s best for you.”
More Foreplay
The improved moisture that typically results from foreplay reduces friction and the possibility of vaginal cuts, says Evins. Increased foreplay gives the vagina the time (and motivation) to naturally lubricate itself.
Sexual Positions
When having sex that involves penetration, certain positions may make vaginal cuts or painful friction more likely, says Evins. “Try positions that allow women more control to reduce the likelihood of vagina cuts,” she says.
Vaginal Estrogen
Post-menopausal women who have issues with vaginal dryness can talk with a provider about using an FDA-approved vaginal estradiol product. Available by prescription, the therapy comes in different forms, including creams, tablets, and vaginal suppositories, says Evins.
Physical Therapy
If your provider determines that your vaginal cuts are related to pelvic floor overactivity, a physical therapist who specializes in pelvic floor issues may help, says Rawlins.
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