Dr. Hanif warmly welcomes you! Thanks for consulting at my virtual clinic. I have carefully worked through your case, and can well realize your health worries. Being your physician, I want to assure, I will take care all of your medical concerns. Mostly pain of this type in this area of body, is due to the strong defecation reflex and need to defecate. It is natural until unless you are busy somewhere else and don t go to bathroom and the reflex increases in intensity causing painful pressure feelings. Sometimes there is infection of the skin in this area. It may be hair follicle infection called folliculitis or simply a boil. It causes pain. If you sit in a chair that causes direct pressure and physical compression is there at this site, it also leads to pain in the perineum. Avoid using such seats to sit in. Infection in rectal area, hemorrhoids, carcinoma of rectum and colon may also cause pain in the area aforementioned. Pilonidal sinus infection on back side may also be misjudged as pain in the area between scrotum and anus. All of this needs a thorough check up. Avoid constipation. It is also a major cause of pain in perineum, left pelvic area and abdomen as a whole sometimes. Hope I answered all of your questions. In future, if you need further, detailed and quick assistance on any health issue, feel free to click on Ask me a question directly from my profile. Have a wonderful time ahead. Regards! DR. MUHAMMAD M. HANIF USA