A frenulum tear is a penile problem that most commonly occurs in men with a short frenulum. A tear can occur after the first time you have sex, and can lead to bleeding and intense pain.

If your frenulum tears, it's important to stop bleeding immediately by applying direct pressure to the area with sterile gauze or a clean cloth. A frenulum tear is more likely to occur during an erection (when there is a higher volume of blood in the tissue), and therefore it can take up to 20 minutes for bleeding to stop.

In most cases, no specific treatment is necessary. The foreskin regenerates and heals on its own after a few days. However, it is recommended to avoid sex while the frenulum is healing, and to maintain good hygiene in the location to prevent future infections.

First-aid steps

To ensure the frenulum heals quickly without complications, you should consider the following steps:

Avoid further trauma to the area, therefore avoid any contact sports with a high risk for injury (e.g. football)
Avoid sex for 3 to 7 days until healing is complete
Wash the genitals after urinating
Apply an over-the-counter cream that promotes healing: this can be applied 2 to 3 times a day

When signs of infection emerge, like pain swelling or redness, you should see your doctor or urologist to start treatment with antibiotic ointment. He or she may prescribe ointments such as fusidic acid or topical bacitracin.

In the first few days of healing, it's normal to experience mild burning at the wound, especially after urinating. However, this discomfort will disappear gradually as the frenulum heals.

Common symptoms

The main symptoms of a frenulum tear include:

Intense pain or burning in the glans, especially during sex
Bleeding

Bleeding caused by the rupture of the foreskin frenulum can be intense, as tears usually occur with an erection, when there is increased blood flow to the penis.

Main cause

The main cause of a frenulum tear is a short frenulum, also referred to as frenulum breve. A shorter frenulum requires greater stretching when the foreskin is retracted, which can increase the risk for a tear during sex.

Additionally, wearing tight or uncomfortable clothing or having penis piercings can also increase the risk for a frenulum tear, as these conditions can weaken the structure of the frenulum.

Often, if the tear does not heal properly, the foreskin frenulum can tear again in the same place. Therefore, it is important to take the necessary precautions to prevent this from happening again.

How to prevent tearing

The best way to prevent a tear in the frenulum is to initiate sex gently, to see whether stretching of the frenulum causes pain. Using a lubricant may also help as it prevents excess friction and pulling of the skin.

If you notice that your frenulum is very short and that it causes discomfort, you can speak to your urologist about whether you are a good candidate for a frenuloplasty. This is a minor surgical procedure which involves a small cut to the frenulum to lengthen it during intercourse.

When to see a doctor

In most cases, treatment can be done at home. However, you are advised to visit the doctor when:

The pain is very intense and does not improve with time
The skin does not heal within a week
There are signs of infection such as swelling, redness, and pus
Bleeding does not decrease with direct pressure

If the frenulum heals and re-tears, you may need to visit a urologist to assess the need for surgical intervention to prevent recurrence.