Fissuring of Posterior Fourchette

[Lauren123]

Hello!

My name is Lauren and I am 22 years old. I have been sexually active in the past (2 years ago), with a long term partner.

I noticed a slight stinging pain at times after intercourse – upon inspection there was a very, very slight tear in the fold below my vagina. I didn’t think much of this, though the stinging sensation was quite irritable. That said, there was only very, very minor bleeding (a spot or two). I figured this was due to lack of lubrication – my partner and I soon began using some, which helped, though the area would still tear.

When that relationship ended, I just ignored/forgot about this issue. I have never been to a gynaecologist (though I am trying to schedule an appointment ASAP). Now I am in a new relationship and we may soon become sexually active. I felt the familiar stinging sensation after being digitally intimate with this partner. I looked and noticed again, a very slight, red/raw spot below my vagina.

I am not trying to overshare on this blog, but I am so concerned! I do not have eczema or any bacterial issues that would cause this problem. In addition, I do not experience any vaginal dryness whatsoever. I understand that using lube couldn’t hurt, and I am willing to incorporate it, but I don’t have any issues with dryness, and I have not been on the pill for over a year. And when I was on the pill, it was for less than a year total.

I know seeing a gynae will help, and perhaps I am misdiagnosing myself, but I am frustrated that I have this issue and that I don’t know how to fix it, what’s causing it, or if it even can be fixed. Any insights are appreciated. And again, I apologize if I have overshared.

[mccartem96]

Hi Lauren,
Thank you so much for sharing about your experience. I think it’s great that you’re working toward getting a gynecologist so you can get some professional insight into your concerns! I did want to comment because I have had this exact problem, but have hit a dead end in trying to identify the exact cause and solution. If I come across anything that could be helpful, I’m happy to send it your way.

[recessivegenequeen]

Hi Lauren123 – welcome to the forums! Never worry about oversharing here, it always helps to have more information to help you figure out what’s going on. I’m not a doctor, but I think seeing a gynecologist is definitely warranted in this situation and any other time your vagina is causing you pain. A few things that could be in play are size of your partner (although you mentioned issues with digital stimulation so that might not be the case) or a more generalized pain issue like vulvodynia. It could be any number of things – a gynecologist visit is definitely the next step to take!

[Hello676]

I have a reoccurrent posterior forcheutte tear that makes it impossible to have sex. Sometimes I refrain from sex for 4-6 months and I gently massage the area and it’s still painful, tender, sensitive, burning type sensation. I’ve been so many specialists and they haven’t helped. Im on birth control but have been for 10+ years and this has only happened for the last 2 years. I can see the cut when my partner takes photos of the area. It doesn’t feel like it ever heals

[recessivegenequeen]

Hi Hello676 – I’m so sorry to hear about this continual painful tearing, that kind of recurrent pain around sex can be so distressing and make a person feel hopeless, especially when you’ve looked for help in so many places. Our bodies change in a lot of ways as we age that have weird effects which bring on issues with things we used to have no problem with. The skin of your vagina may have gotten more sensitive over time (even to birth control) because of the aging process. I’m sure you’ve tried a lot of things but I hope you will keep seeking answers because you don’t deserve to be in this much pain! There are a lot more causes for vaginal pain than even most gynecologists are familiar with. I hope you can find relief and answers soon.

[mazemelissa]

I would still consider a hormonal issue based on the long term use of birth control pills. Sometimes it can take years for the tissue to become damaged from the lack of hormones.

If you haven’t tried a topical hormone cream massaged into the area daily, or even twice daily, I would start there.

I often try to switch my patients to a different method, maybe an IUD, and then use topical estrogen or estrogen and testosterone to the area.

It can take months for the area to respond and heal, but often my patients will find some improvement after a month.

[Livvy]

I’ve been dealing with a similar problem for a similar timeframe – on birth control for about a decade, started getting a recurrent fissure a couple years ago – and found this forum with the suggestions of stopping BC and starting a topical estrogen cream. But when I mentioned it to my gynecologist, she said birth control shouldn’t cause this and the estrogen cream wouldn’t help because the birth control already has estrogen in it. Are there any resources I could send her that might convince her this is a viable treatment option? Or ways to get the cream without going through my gynecologist? I’ve already stopped my BC – I got a bisalp a year and a half ago so I was really just using the pills to regulate my period – but I’m afraid she won’t go for the hormone cream without evidence.

I’ve also seen some answers suggesting an estrogen cream and some answers suggesting estrogen + testosterone – is there any evidence of one being more effective than the other? It’s been so long since I’ve been able to have sex without stressing out and tearing and I’d really like to get my sex drive back.