Vaginal and Vulval Lumps, Lesions and Cysts
Vaginal and vulval lumps, lesions and cysts are growths or changes that develop in or around the vaginal opening, vulva or vaginal walls. Most are benign (non-cancerous) and may include cysts, skin tags or normal anatomical variations. However, any new or persistent lump should be assessed to confirm the diagnosis and determine whether treatment is needed.
Commonality
Vulval and vaginal lumps are common, and many women experience them at some point in their lives. Most are benign and do not represent a serious health problem.
Causes
There are many possible causes of vulval and vaginal lumps.
Common causes include:
Bartholin’s cysts – fluid-filled swellings that develop near the vaginal opening
Sebaceous cysts – small, firm lumps beneath the skin caused by blocked hair follicles or oil glands
Fordyce spots – tiny pale or white spots that are completely harmless and require no treatment.
Skin tags – soft, flesh-coloured growths that may develop due to friction or hormonal changes
Vestibular papillomatosis – small, symmetrical projections around the vaginal opening that are a normal anatomical variation and often mistaken for genital warts
Gartner’s duct cysts – cysts that form along the vaginal wall due to remnants of embryological tissue
Vaginal inclusion cysts – small, usually benign cysts that develop within the vaginal wall
Lipomas – fatty lumps
Swollen lymph nodes – caused by irritation or infection
Symptoms
Many vulval and vaginal lumps cause no symptoms and are discovered incidentally.
When symptoms occur, they may include:
A visible or palpable lump
Pressure or discomfort
Pain or tenderness
Persistent itching
Bleeding or ulceration
Changes in colour, texture or shape
Unusual vaginal discharge or odour
Effects on Fertility
Diagnosis
Assessment may include:
Review of symptoms and medical history
Examination of the vulval and vaginal area
Swabs if infection is suspected
Vulvoscopy or colposcopy to examine the tissue in greater detail
Biopsy of suspicious lesions when required
These investigations help determine whether the lesion is benign or requires further treatment.
Treatments
Treatment depends on the type of lesion and whether it is causing symptoms.
Treatment options may include:
Bartholin’s cyst treatment
Drainage
Marsupialisation (a small permanent opening)
Surgical removal for recurrent cysts
Cyst removal
Removal of sebaceous or inclusion cysts when symptomatic
Medical treatment
Topical medication for skin conditions such as eczema, lichen sclerosus or herpes
Treatment of underlying infections where present
Biopsy or surgical treatment
Further investigation or removal of abnormal lesions where necessary
Many minor procedures can be performed in an outpatient setting.
Ongoing Care
Living with the Condition
Discovering a lump or lesion in the vulval or vaginal area can be worrying and may cause embarrassment or anxiety. However, most vulval and vaginal lumps are benign and can be managed effectively once diagnosed.
Helpful self-care measures include:
Wearing breathable cotton underwear
Avoiding tight clothing and irritants
Maintaining good genital hygiene
Practising safe sex
Seeking medical advice if a lump persists or changes
Early assessment often provides reassurance and allows prompt treatment where needed.
When to See a Specialist
You should seek specialist assessment if you notice:
A lump that persists for several weeks
Rapid growth or spreading lesions
Persistent itching or pain
Bleeding or ulceration
Hard, irregular or fixed lumps
Changes in colour, texture or shape
Unusual vaginal discharge or odour
Early assessment helps ensure appropriate diagnosis, treatment and reassurance.