I Am Worried About a Lump on my Vagina

>> Thursday, February 12, 2015

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The vulva, labia, vaginal opening (vestibule) and mons pubis (top part where most of the hair grows) are the most sensitive areas on a woman's body. This is why we notice any bump or rash right away, and may worry that it could be something really bad. So let me describe the many lumps & bumps that can show up down there.

Most women never look at themselves in these areas until there is something wrong. I've had many women come in because they have a fungal infection and felt bumps inside their vagina. When I examine them there are no abnormal bumps (because the vaginal walls are bumpy). But when we have an infection they can be swollen and irritated so they are much more noticeable.

The vestibule can have mucosal cysts, which are small, soft and painless lumps which can be removed if desired but can also be ignored if it is causing no pain.

There are many cysts that can form from blocked sweat glands. They tend to occur along lines of friction, especially where our panties rub throughout the day. These can be simple pimple-like cysts, sebaceous cysts, or even small skin tags like we see under the neck line or armpits in many people.

Fordyce spots are small white or yellow lumps, 1-3mm in diameter on the labia minora. They are painless. These are slightly enlarged sebaceous (oil) glands and are completely harmless. They often become more easily seen at puberty and with pregnancy and hormone treatment. They are benign and will often come and go or rupture after awhile. Some women are more prone to them and can even get them on their inner thighs. Antibiotics can help clear them.

Vestibular papillomatosis is a condition where the surface of the entrance of the vagina and inner labia minora becomes a bit thicker following puberty and in pregnancy. This gives a very fine, frond-like, slightly warty appearance to the skin, so it can be mistaken for warts. This is a normal variance for some people and doesn’t need or respond to treatment.

Angiokeratomas are tiny clusters of dilated blood vessels with a scaly top, seen after puberty and usually on the labia majora. They tend to become more numerous in older age. They are bright red initially but can become darker, almost black later on. Very occasionally they can bleed slightly if bumped or rubbed too hard. Other than that they don’t cause symptoms and are harmless. If they are causing problems they can easily be removed in the doctor's office.

Hymenal remnants are vaginal skin protrusions from the stretching and friction that occurs during intercourse and vaginal birth.
It is common to have irregular protrusions around the area of the hymen, the outer ring of the vagina. These rarely cause problems, but can be removed if they are bothersome.

Seborrhoeic keratoses are harmless warty-looking lesions found all over the skin in increasing numbers as we age. They are found on the labia majora and mons pubis in women from the thirties onwards. They are often dark in color and small (less than a centimeter). They can be solitary or multiple. They are benign and can be removed if you don't like how they look, but will never become cancerous.

Varicose veins are very common, especially during and just after childbirth. They can give the vulva a purple look, and may cause aching, especially at the end of the day. The veins in the labia majora or minora can become enlarged and tortuous. They rarely cause problems with delivery of the baby and will often shrink back after delivery. It worries some women as they see dark and black veins and just were unaware that this happens.

Hidradenitis suppurtiva is a big name for clogged sweat glands, and we have a lot of sweat glands down there. Women notice them during yeast and bacterial infections because of the increased puritis and swelling.

Waxing and shaving can cause an infection of the hair follicles causing swollen red spots and itching. These can be prevented by not sharing your razor and changing the blades after 3-4 uses.

The other common lumps come from clogging of Skene's glands or Bartholin's glands. Skene's glands are up around our urethra and Bartholin's sit lower at the opening of the vagina on both sides. They are usually painless but if they become infected will cause horrible pain. These are easily opened and drained, and then treated with antibiotic therapy.

Regardless of the lump, it is important to see your doctor to make sure all is well. Lumps and bumps do not always mean herpes or condyloma (warts).
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