Bruising is medically possible in the genital area, which often causes concern due to the sensitivity of the tissues. A bruise, technically called a contusion, develops when trauma damages the skin and underlying tissues. This article clarifies why genital bruising happens, what signs to look for, and how to manage the injury to promote recovery.
Understanding the Possibility of Bruising
The external genital area, known as the vulva, is susceptible to bruising due to its rich blood supply and delicate structure. A contusion occurs when force damages small blood vessels beneath the skin, causing blood to leak into the surrounding tissue. This pooling of blood creates the characteristic discoloration.
The vulva, which includes the labia majora and minora, is highly vascularized, containing a dense network of blood vessels. The loose connective tissue allows blood to collect easily, making the resulting bruise or swelling more prominent than in other areas. Bruising is most common on the external vulvar tissue; injury deeper within the internal canal is less frequent and often more serious.
Common Causes of Trauma
Physical force is the direct cause of a bruise, and several common activities can result in trauma. One frequent cause is vigorous sexual activity, particularly when there is insufficient lubrication or forceful contact with underlying bony structures. Deep penetration can sometimes lead to a “bruised cervix,” which is a distinct, painful injury at the top of the internal canal.
Accidental injuries, such as falls involving landing on a hard object or “straddle injuries,” are also common causes of vulvar bruising. Activities like cycling, horseback riding, or gymnastics can create prolonged pressure or friction, leading to minor soft tissue damage. Childbirth is a significant source of trauma, often resulting in bruising and hematoma formation from the extensive stretching of the birth canal, especially following instrument-assisted deliveries.
Recognizing Symptoms and Immediate Care
A typical bruise in the genital area presents with symptoms similar to a contusion elsewhere on the body, beginning with localized pain or tenderness. Discoloration is a hallmark sign, often appearing as shades of red, purple, or blue. This discoloration gradually fades to green and yellow as the body reabsorbs the blood. Swelling is also common due to blood pooling in the loose connective tissue, and the area may feel sensitive to the touch.
For minor bruising, at-home care focuses on reducing swelling and managing discomfort. Applying a gentle cold compress, such as a cold wet washcloth, for about 20 minutes at a time helps constrict blood vessels and limit internal bleeding. Cold therapy should only be used if tolerated and must not be applied directly to the skin without a barrier. Rest and avoiding activities that caused the trauma, such as straddling or high-impact exercise, are also important steps in recovery.
Over-the-counter pain relievers, such as ibuprofen or acetaminophen, are effective for managing pain and inflammation. Avoid friction and heat, as these can increase blood flow to the area and potentially worsen swelling. Sitting on a doughnut-shaped pillow may also provide relief by reducing pressure on the injured area.
When to Consult a Healthcare Provider
While most genital bruises are minor and heal on their own, certain symptoms indicate a more severe injury, such as a hematoma, requiring medical attention. Rapid, severe, or expanding swelling should prompt an immediate consultation, as this suggests a larger damaged blood vessel and a significant collection of blood. Severe, unmanageable pain not relieved by over-the-counter medication is another sign that the injury is more extensive.
Difficulties with urination, such as an inability to pass urine or the presence of blood, can signal that swelling or a hematoma is pressing on the urethra. Signs of infection also warrant prompt medical evaluation. These include:
- A fever of 100.4°F or higher.
- The appearance of pus.
- Skin around the injury becoming very red and warm to the touch.
Any persistent bleeding unrelated to the menstrual cycle, or symptoms that fail to improve after 7 to 10 days, suggests a need for examination to rule out complications.