Last Tuesday, the 30th, a 19-year-old girl died after having sex with the Corinthians under-20 player, Dimas Cândido de Oliveira Filho, aged 19, as reported by Estadão. The young woman’s death certificate indicates the cause of death “Douglas cul-de-sac rupture extending to the left vaginal wall”.
What is Douglas sac?
This is the highest portion of the vaginal wall, which surrounds the cervix. Also called cul-de-sac of Douglas or vaginal fornices, the region tends to accumulate pressure from the air that enters the vagina – and, if this pressure is too high, it may rupture.
According to gynecologist and obstetrician Eduardo de Souza, coordinator of the Maternity Unit at Hospital São Luiz Anália Franco, in São Paulo, the rupture of this region is not usually due to violence or the size of the genitals, but rather to the entry of air and of the increase in pressure.
“The increase in pressure in the region it can cause the vaginal mucosa to extend by a few centimeters. This can affect blood vessels and lead to serious bleeding”, he points out.
How to avoid rupturing the sac of Douglas?
The specialist explains that some sexual positions, such as the one in which the woman is on all fours, have a greater risk of air entering the vagina and, consequently, tearing the region. Therefore, Souza advises observing noises during sexual intercourse that may signal air entering the vagina and, if this is the case, changing position.
The gynecologist also notes that the use of inappropriate sex toys (too large, pointed or made with hard materials) or used incorrectly can also result in the rupture of the Douglas sac.
What to do if the sac of Douglas ruptures?
If heavy bleeding occurs during sexual intercourse, which may indicate rupture of the sac of Douglas, it is important to seek medical attention as soon as possible. According to Souza, treatment is normally carried out with anesthesia and suturing the region to stop bleeding.
Ideally, however, the bleeding should stop even before arriving at the hospital. “It is recommended to cover the vaginal area with a towel or sheet. These accessories should be gently introduced into the vagina so that the woman loses less blood”, she advises.
What are the risk factors for breakup?
According to the expert, women with a weaker vaginal mucosa, such as those who are breastfeeding, those who are in menopause and those who have just given birth, are at greater risk of having the sac of Douglas rupture. “This does not prevent, however, women outside these criteria from going through this situation.”