Vaginal Sores and Lumps: Why They Happen and How to Treat Them

Vaginal Sores and Lumps-MainPhoto

Vaginal Sores and Lumps-MainPhoto

Sores (ulcers), blisters, pimples and lumps can form inside or nearby the vagina. These changes can occur with or without pain. This guide is intended to provide you with a better understanding of what may be causing your problem, if you have one of these changes. This guide is not intended to substitute for an in-office evaluation by your doctor.

Please choose the concern that fits best:

My concern is an ulcer, blister, or pimple

My concern is a lump, growth, or swelling

Which of these two descriptions fits your problem best?

A rough or lumpy growth that looks “stuck on”

A large bulge, swelling, or fullness

Normally, the uterus, bladder, and rectum are each supported so that they are not pressing against the vaginal canal. As women age, the muscles in the pelvic floor can weaken. In addition, the ligaments that hold the uterus in place can weaken or stretch. These changes are particularly common after childbirth. An organ that loses its support can then “slump” from its usual position, so that it presses against the vaginal canal and creates a bulge in the wall of the vagina. Sometimes a bulge from an adjacent organ can be felt pushing out of the vagina or seen bulging from the vagina.

A bulge in the vagina from the rectum is called rectocele. A bulge in the vagina from the uterus is called uterine prolapse. A bulge from the bladder is called a bladder prolapse or a cystocele.

None of these conditions are dangerous but they may cause symptoms such as a moist deposit in the underwear, a pulling or heavy feeling in the vagina, constipation and urinary leakage. If you think you have a lump pushing out of your vagina like this, you should discuss it with your doctor. There are ways to treat this if it is causing symptoms.

Treatment usually starts with the use of a ring called a pessary that your doctor can insert in the vagina to hold things in place. Surgery is available if it is necessary.

The most common things that would cause a change in the surface tissue inside the vagina are either normal folds of tissue or genital warts.

Warts are painless, skin-colored or pink growths. Usually warts appear in a cluster and each wart is usually quite small (less than half the size of a pencil eraser.) Genital warts are caused by infection with human papillomavirus (HPV), an infection that is spread through sexual contact. Warts can occur on the outside or the inside of the vagina, and they can also appear around the anus.

HPV is very contagious and is transmitted by skin to skin contact. Condoms may decrease the risk of transmission but HPV can still be spread when condoms are used. You should avoid sexual contact with your partner if you have active warts. In most cases, the body will eventually clear the virus completely, but this may take years.

Certain types of HPV can cause cervical cancer. However, the types of HPV that cause cervical cancer are usually not the same types as those that cause genital warts. Regular pap smears should be done in all women to screen for cervical cancer since the various types of HPV are so common.

Cancer of the vagina is rare, but it does occur. Your doctor will want to examine your lump or bump so that he or she can make sure this it is not a cancer.

Your doctor will want to examine your lump or bump so that he or she can make sure this is not a cancer.

The most common cause of a skin lump in the genital area is a skin tag, genital warts, or a boil.

Skin tags are painless, skin-colored or pink growths. Warts are also painless, skin-colored or pink growths, but usually there is more than one wart at a time and each wart is usually quite small (less than half the size of a pencil eraser.) Genital warts are caused by infection with human papillomavirus, an infection that is spread through sexual contact.

If you think you may have had a sexual exposure that could put you at risk for a sexually passed infection, you should also have your doctor inspect the area of concern to see if it might be caused by an infection with syphilis. Usually, syphilis causes a skin ulcer but it can cause lumpy skin as well.

One large pimple may be an infected hair follicle is called a furuncle (boil). A furuncle in the genital area may be from a type of acne named hidradenitis suppurativa. Your doctor may need to treat you with antibiotics if you have an infection.

Cancer in the genital area is rare, but it does occur.

Your doctor will want to examine your lump or bump so that he or she can make sure this is not a cancer.

Which of these two descriptions fits your problem best?

A rough or lumpy growth that looks “stuck on”

A bulge, swelling, or fullness

A very common cause of a single lump at the entrance to the vagina is a cyst called a Bartholin’s gland cyst. It is likely that this is your diagnosis.

The Bartholin’s gland makes the fluid that lubricates the vagina. If the gland gets blocked, the fluid can get trapped inside and form a cyst. This is usually not painful. If the cyst gets infected, it is called an abscess and it can be very painful.

Usually, a Bartholin’s gland cyst creates a smooth bulge or swelling. The lump is sometimes as large as an inch across or larger. This bulge can appear on one side of the entrance to the vagina, where the soft moist pink tissue begins, or it can cause swelling of the skin-covered portion of the labia (the vulva) on one side. This bulge may be painless, or it may be tender.

Cysts usually heal on their own. Abscesses may need to be drained by a health care provider. Warm compresses can help open up the cysts and let the fluid drain out.

If you have a painful Bartholin’s gland cyst or a swelling that doesn’t go away on its own after several days, see your doctor for evaluation and treatment.

The two most common things that would cause a change in the surface tissue at the entrance to the vagina are skin tags or genital warts.

Skin tags are painless, skin-colored or pink growths. They don’t require treatment.

Warts are also painless, skin-colored or pink growths, but usually there is more than one wart at a time and each wart is usually quite small (less than half the size of a pencil eraser.) Genital warts are caused by infection with human papillomavirus (HPV), an infection that is spread through sexual contact. Warts can occur on the outside or the inside of the vagina, and they can also appear around the anus.

HPV is very contagious and is transmitted by skin to skin contact. Condoms may decrease the risk of transmission but HPV can still be spread when condoms are used. You should avoid sexual contact with your partner if you have active warts. In most cases, the body will eventually clear the virus completely, but this may take years.

Certain types of HPV can cause cervical cancer. However, the types of HPV that cause cervical cancer are usually not the same types as those that cause genital warts. Regular pap smears should be done in all women to screen for cervical cancer since the various types of HPV are so common.

Cancer is rare in this area of the body, but it does occur. Your doctor will want to examine your lump so that he or she can make sure this it is not a cancer.

Your doctor will want to examine your lump so that he or she can make sure this is not a cancer.

The presence of a sore always raises concern about the possibility of a sexually transmitted infection. Certain behaviors put people at greater risk for sexually transmitted diseases. These risk factors include:

  • multiple sexual partners
  • intercourse (sex) without the protection of a condom

Is there any chance that you have a sexually transmitted infection?

Yes, I may be at risk

No, I am definitely not at risk

Is your problem inside the vagina (on the moist pink tissue) or outside the vagina (on the skin-covered tissue)?

Inside the vagina

Outside the vagina

Ulcers or inside the vagina or breaks in the surface lining of the vagina can be caused by irritation. If you have been using a cosmetic product, latex condoms or a spermicide, it is possible you may have an allergic reaction or a contact dermatitis.

If you do have blisters or ulcers inside the vagina, genital herpes is the most common cause. Even though you do not think you are at high risk for having a sexually passed infection, you should see your doctor for an evaluation if you have blisters or skin ulcers in the vaginal area.

After menopause, an ulcer can result due to too little estrogen. This problem is named atrophic vaginitis.

A blister or pimple (or collection of these) containing cloudy fluid (pus) may be from an infection of a hair follicle. A collection of several infected hairs is named folliculitis, which is a form of staph or strep infection. One large pimple that is an infected hair follicle is called a furuncle (boil). A furuncle in the genital area may be from a type of acne named hidradenitis suppurativa. Your doctor may need to treat you with antibiotics if you have one of these infections.

Pimples at the edge of a red rash may be caused by a yeast infection. The yeast infection that is most common in the vaginal area is “candidiasis.”

Blisters with clear fluid or skin ulcers may be caused by contact dermatitis (sometimes from cosmetic products), but genital herpes is a much more common explanation. Even though you do not think you are at high risk for having a sexually passed infection, you should see your doctor for an evaluation if you have blisters or skin ulcers in the vaginal area.

Very rarely, an ulcer on the skin near the vagina can be caused by cancer.

Is your ulcer, blister, or pimple (or collection of these) painful?

Yes, it is painful.

No, it isn’t painful

An ulcer or cold sore can be caused by the sexually transmitted infection, syphilis. When syphilis creates a skin ulcer (skin sore), the ulcer is usually not painful.

If your problem looks like one or more pimples and if it is outside of your vagina, it may be acne or a type of acne named hidradenitis suppurativa. Your doctor should examine you to make your diagnosis.

Your doctor should examine you to make your diagnosis.

You may have herpes. Make an appointment to see a health care professional within the next several days. Avoid any sexual contact until you have been medically evaluated.

Painful ulcers (sores) or blisters are commonly caused by the herpes virus. The sores usually heal in one to two weeks but can come back multiple times. There are several antiviral medicines (acyclovir, valacyclovir or famciclovir) that can shorten the length of the herpes outbreak. These medicines can also be used to prevent future outbreaks. However, it cannot cure the virus and make it go away forever.

The herpes virus is very contagious and you should not have any sexual contact while you have an active infection. Condoms can help decrease the risk of viral transmission, but there is no guaranteed way to prevent transmission between sexual partners. The virus can be spread even when no active sores are present.

If you think you may have a herpes infection, you should visit your doctor while your outbreak is occurring so your diagnosis can be confirmed. If your symptoms return frequently, you may choose to take medicine regularly to prevent future episodes. You should discuss your infection with your partner and use condoms to minimize the chance you will pass the infection to your partner.

If you have a blister or pimple (or collection of these) containing cloudy fluid (pus), then you may have a different diagnosis. A collection of several pimples could be from folliculitis (infection of hair follicles), which is a form of staph or strep infection. One large pimple that is an infected hair follicle is called a furuncle (boil). A furuncle in the genital area may be from a type of acne named hidradenitis suppurativa. Your doctor may need to treat you with antibiotics if you have one of these infections.

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