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Anonymous on September 26, 2011

I have a large, hard bump on the lip of my vagina. What could it be?

I’m a 21-year old female. I’ve been married for several months, and my husband and I have been together for several years. I recently noticed a large bump on the lip of my vagina. I don’t think it can be herpes, warts or another STD because I get tested every six months. My husband gets tested, too, even though he was a virgin prior to our marriage. The bump isn’t sore (unless I press on it) or itchy. It is skin-colored and hard as a rock. What could this be?

answered by Lisa Oldson, MD on September 26, 2011

Thank you for taking the time to share your concerns with us. It can be alarming to find something unusual on or near your vaginal area...I will try to help you understand some possible causes, but the only way to know for sure what the bump is will be to visit your doctor.

Sometimes, women develop non-STD bumps on their genitals. Cysts on the labia (the lips of the vagina) can look like bumps, but they’re typically not “hard as a rock” as you describe. Some other causes include an infected ingrown hair, a pimple, or a boil.

Although, again, you can’t be diagnosed without an examination, your description of a hard bump is similar to a description of genital warts.

Genital warts, caused by some types of the human papillomavirus (HPV), can be spread through skin-to-skin contact...including, but not limited to, vaginal, anal or oral sex. Most people with HPV don’t have visible warts, but can still pass the virus to others. So you might not have known if a past partner ⎼ or even your husband ⎼ was a carrier.

Upon a visual examination of your bump, your doctor will be able to tell you whether you have genital warts, or perhaps something harmless...like a skin irritation or a cyst. Your doctor might also decide to do a Pap test, to look for a different kind of HPV that causes cervical cancer (note: the types of HPV that cause genital warts and the types that cause cervical cancer are different).

Unfortunately, there’s not yet a reliable HPV test for men, with the exception of men who practice anal receptive sex...they can have an anal Pap smear to check for HPV.

A single, firm and painless sore could also be a potential symptom of an early syphilis infection. Be aware that syphilis sores may appear to heal without treatment in a few weeks...but the syphilis infection will still be in the body and remain infectious. And without treatment, syphilis infection can potentially cause more serious health problems in the future.

I encourage you to visit your doctor for an examination and potentially get tested for a full set of common STDs...again. Follow your doctor’s instructions for the best course of action and treatment for your condition. For example, genital warts can be managed with topical medication and most people will fight off the virus within several years, and syphilis is curable with a dose of antibiotics.

When you get tested, be sure to ask for the specific tests you want. I’m pleased that you and your husband get tested regularly, but do you know which STDs you’re getting tested for? Doctors generally don’t test for STDs across the board unless you specifically ask them to...so be sure to ask for chlamydia and gonorrhea tests, as well as syphilis, herpes, HIV and hepatitis B and C tests.

Then, once you know each other’s STD status for sure, you can get treated, if necessary. For more information about STD risks, symptoms, testing, treatment and prevention, see our Expert Guide to STD Basics. You might also want to check out our Expert Guide to Syphilis.

That said, although regular STD testing is a great tool for staying healthy, people in low-risk relationships don’t usually need to be tested every six months as you describe. What makes a relationship low risk? If you’re in a mutually monogamous relationship (in other words, you only have sex with your husband and he only has sex with you), and you’ve both been tested (and treated, if necessary) for common STDs, then getting testing every six months is probably more often than you need.

Thanks again for writing, and I wish you and your husband a quick resolution to your discomfort.

Related info:

Lisa Oldson, MD

Dr. Oldson is Medical Director of the Analyte Physicians Group. She is on staff at Northwestern Memorial Hospital, as well as Clinical Instructor at the Feinberg School of Medicine, Northwestern University. Her areas of expertise include STDs (with a particular clinical emphasis on herpes), women's health, preventive medicine, diabetes, obesity and weight management, and mood and anxiety disorders. Dr. Oldson was educated at Rush Medical College and completed her residency at Rush-Presbyterian-St. Luke's Medical Center in Chicago, IL.

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