Vulval and vaginal lumps: symptoms, diagnosis and treatment

Sometimes lumps and bumps develop in the vagina or on the vulva, the external area that includes the labia. They can happen for many reasons and can cause discomfort or pain. Vulval and vaginal lumps are common, especially during the childbearing years and as you get older, and most are harmless. Even so, it is always a good idea to see your doctor if you are unsure about a change.

When should vaginal lumps be checked?

See your doctor if you have a new lump that does not go away within a few weeks. You should also see a doctor if a lump is painful or shows signs of infection, such as discharge containing pus or blood, or if you have symptoms of a sexually transmitted infection.

Common causes of vaginal lumps

1. Vaginal cysts. These are small, pouch-like swellings on the vaginal wall. Some contain fluid or pus, and others form around scar tissue. Most are small and cause no symptoms, although some can become large and painful. Types include:

• Bartholin's cysts, lumps on one or both sides of the vaginal opening
• endometriosis cysts, small cysts of endometriosis tissue in the vagina (see endometriosis)
• Gartner's duct cysts, which typically form during pregnancy
• vaginal inclusion cysts, which often follow an injury to the vaginal wall, for example during childbirth

2. Vaginal polyps. These are small outgrowths of skin, sometimes called skin tags. They usually need no treatment unless they are painful or bleed.

3. Warts and herpes. Genital warts are caused by human papillomavirus (HPV), a sexually transmitted infection that is also a risk factor for cancer. Warts inside the vagina are hard to feel, but small, irregular growths may be noticed just outside the opening. Herpes, another sexually transmitted infection, can cause blisters or sores that sometimes look like a spot or an ingrown hair.

4. Cancer. Rarely, vaginal cancer or vulval cancer can cause a lump. Other symptoms of vaginal cancer include unusual bleeding or discharge and, if advanced, constipation, pelvic pain, back pain or leg swelling. These symptoms are much more likely to have another cause, such as an infection, but they should always be checked.

How are vaginal lumps diagnosed?

Your doctor will examine the vulva and vagina and ask about your symptoms. They may take a swab from the lump to test for infection or abnormal cells, or a small biopsy if needed. Imaging, such as a transvaginal or abdominal ultrasound, can show how large a lump is (see gynaecological ultrasounds). Cancer Research UK lists the symptoms of vulval cancer that should always be assessed.

How are vaginal lumps treated?

Many vaginal lumps need no treatment at all. When they do, treatment depends on the cause. Infections are treated with medicine, and cysts that keep returning or cause pain can be drained or removed. For most minor lumps, these simple steps can help ease symptoms:

• take a warm bath a few times a day for a few days, which may help a cyst to drain
• avoid tight clothing that rubs or chafes the vulva
• wear breathable cotton underwear to keep the area cool and dry

It is unlikely that a vaginal lump is a cause for alarm. Most go away by themselves or can easily be treated. If you have a sexually transmitted infection, early treatment reduces the risk of complications. The Royal College of Obstetricians and Gynaecologists has patient information on vulval conditions, and our vulval and vaginal lumps page has more detail. To book a consultation with Mr Jafaru Abu, please get in touch.