A vaginal hematoma is a collection of blood that pools in the soft tissues of the vagina or vulva, which is the outer part of the vagina. It happens when nearby blood vessels break, usually due to an injury. Blood from these broken vessels can leak into surrounding tissues. You can think of it as a kind of deep bruise.

Keep reading to learn more about the symptoms of a vaginal hematoma and what kind of treatments are available.

In many cases, a small vaginal hematoma won’t cause any symptoms. Larger hematomas may cause:

  • Pain and swelling. You may be able to feel or see a mass covered by purple- or blue-colored skin, similar to a bruise.
  • Painful or difficult urination. If the mass puts pressure on your urethra or blocks your vaginal opening, you might have hard time urinating. This pressure can also make it painful.
  • Bulging tissue. Very large hematomas sometimes extend outside of the vagina.

Vaginal hematomas, like all hematomas, are usually the result of an injury. The vagina contains a lot of blood vessels, especially in comparison to other areas of the body.

Several things can injure the vagina, including:

  • falling
  • vigorous sexual intercourse
  • high-impact sports

This type of hematoma can also happen during vaginal childbirth, either due to pressure from pushing or injuries from medical instruments, including forceps. Having an episiotomy can also cause a vaginal hematoma. This refers to a surgical cut near the vaginal opening to make it easier for a baby to pass through it. Vaginal hematomas caused by childbirth may not show up until a day or two after giving birth.

To diagnose a vaginal hematoma, your doctor will start by doing a basic exam of your vulva and vagina to check for any visible signs of a hematoma. Depending on what they find during the exam, your doctor might also order an ultrasound or CT scan to see how big the hematoma is and whether it’s growing.

Vaginal hematomas can sometimes lead to dangerous bleeding, so it’s a good idea to check in with your doctor, even if the hematoma seems minor.

There are several treatment options for vaginal hematomas, depending on how large they are and whether they’re causing symptoms.

A small hematoma, usually under 5 centimeters in diameter, is usually manageable with over-the-counter pain relievers. You can also apply a cold compress to the area to reduce swelling.

If you have a larger vaginal hematoma, your doctor may need to surgically drain it. To do this, they’ll start by numbing the area with a local anesthetic. Next, they’ll make a small incision in the hematoma and use a small tube to drain the pooled blood. Once the blood is gone, they’ll stitch up the area. You might also be given an antibiotic to prevent an infection.

Very large hematomas, or hematomas located deep in the vagina, may require heavier sedation and more extensive surgery.

Vaginal hematomas are relatively rare. When they do happen, it’s usually the result of an injury or childbirth. The vagina is rich in blood vessels, so any kind of trauma in this area can cause a hematoma. While small ones often heal on their own, larger ones may need to be drained by your doctor. Regardless of the size, it’s best to make an appointment with your doctor to make sure you don’t have any internal bleeding.