Bumps Down There

Happy New Year!

In this podcast episode I discuss some of the common lumps and bumps on our most intimate area. I see these in my office all the time and its important to understand what you may or may not have. 
Is it a..
1. Bartholin's  gland cyst
2. Epidermal inclusion cyst
3. Ingrown hair
4. Folliculitis
5. Genital warts
6. Herpes

Listen to find out!

Transcript

SPEAKER_00 0:00

Hi guys, welcome to another episode of the Four Vaginas Only podcast. In this episode, we're gonna talk about the bumps down there. So there are a host of things that can happen on the vulva, which is the outside part of the vagina, that can look like a bump and freak people out, and we're gonna talk about that. Some of you I'll put your mind at ease, some of you I'll have you making sure you get checked at your doctor. But either way, it's important to talk about it. But first, let's cue the music. Hello and welcome to For Vaginas Only, the podcast about everything female. I'm your host, Dr. Celestine, bringing you important information about understanding your health and body in the way you wish your doctor would actually explain it. Okay, so let's talk about the bumps that can happen on the vulva and in the vagina. I'm Dr. Celestine, your host of the Four Vaginas Only podcast. And in this episode, we're gonna talk about all the little lumps and bumps that freak you out. So let's hop right into it. I want to start by saying a lot of the bumps that happen, especially on the bul the vulva and in the vagina, can be, you know, something that's not too scary, something that we can manage. And there are a few, one in particular I'm gonna talk about that's a little bit more concerning. So, first and foremost, let's talk about a lump or bump that can happen in the vagina. It actually happens in the lower half of the opening of your vagina, and you can have a bump on each side of the lower part of the opening. And that's because this is the area where the Bartholin's gland exists. The Barthelin's gland, you have multiple glands in the vagina that you don't even realize that you have. The skeins gland, for example, but this one's called the Bartholin's gland, and that's the location of it. For the Bartholens gland and these other glands, they secrete what we call sebaceous fluid. It's just like fluid that gets secreted here and there to keep the vagina moist. Sometimes it's secreted more when you're sexually aroused, but it's an opening in the skin, which is what a gland is, and it secretes the fluid through that opening. Sometimes, though, that opening can get covered or blocked. Um, whether it's like somebody, some people can get them frequently for no reason. Sometimes it actually happens like for overactivity, sexual activity in that area. Little things can happen that can end up blocking or covering that gland. Now, if you think of a gland that needs to secrete its fluid, if it's blocked, the fluid is gonna build up, and then that's when you get a bump in that lower part of the opening of the vagina. So that's called a Bartholens gland cyst. Now, it can be a cyst, which is normal fluid that builds up in there, not too painful, not too like red or anything like that, or it can turn into an abscess. If that fluid sits there long enough, is not treated or does not go away, it can get very painful, very red, very hard to sit down, feels like you're sitting down on a lump. That's when it's turned into an abscess because now it's infected. So the Bartholens gland, cyst or abscess, it can be treated in multiple ways. So one of the ways that we treat it, especially if it's not infected, can be just with warm compresses to the area or sitting in a warm cits bath. We can sometimes provide antibiotics just to help any mild inflammation go away. We especially provide antibiotics if it is infected. The other way we treat it is what we call an incision and drainage or an IND. That's where your doctor actually goes in with a scalpel and cuts open the little cyst or abscess in order to drain what's inside of it because sometimes it needs to come out, especially if it's infected. And some people will have these cysts over and over and over for whatever reason. And if that's the case, we might do some more long-term management. Yes, we still have to open it, but we might put a little catheter inside while, like inside that little opening we made while it's healing, in order to keep the gland open while it's healing. And a step further is something called marsupialization. That's when you have them very frequently, these Bartholin cysts or abscesses. And you have to actually get the gland kind of filleted out open, which sounds crazy, but it's a common thing that we can do, and that permanently keeps that gland open while it's healing, so that you maintain that tract and it doesn't get continually covered and blocked. So that's a Bartholens gland cyst or abscess. Now, a second thing that can be a bump down there, and I actually see these really, really commonly, is something called an epidermal inclusion cyst. An epidermal inclusion cyst, how it will appear, is just a lump on the labia usually, so the outer lips of the vagina, and it's almost like skin colored, can look a little bit white, and it's stable. Um, most of the time it doesn't really grow that fast, or it can like, you know, grow a little bit over time. It's not painful at all, and it kind of just looks like a white lump. So that's an epidermal inclusion cyst. Now, the cause why it happens, some people it just happens, you know, out of nowhere, happens on its own. Sometimes it can be an injury or some sort of trauma to the vulva, or it can be a little gland there underneath each hair follicle, also has glands that secrete a little bit of fluid to keep your skin moist, believe it or not. And sometimes that gland can get blocked, and that little bit of fluid, again, similar to the Bartholin cysts, can not be able to come out and cause this inclusion cyst. So the way that we treat this, some of these, some people have had these epidermal inclusion cysts forever, they haven't changed, and we don't have to do anything about it. Others are getting like bigger, uncomfortable, and want it to be removed. So if that's the case, then we do again an incision and drainage where we cut open the area, squeeze out the material that's inside of it, and let it heal. And that's an epidermal inclusion cyst. Now, the third bump down there that I want to discuss today is an ingrown hair. Now, a lot of you are really familiar with this, but sometimes people come to my office because they're not really quite sure what it is, whether it's you've just started shaving or waxing and all of a sudden you're getting one for the first time. Hint hint, those are some causes. But it's really a lump, again, on the outer lips of the vagina, the labia. Um, sometimes they can be painful, um, or sometimes you don't have any pain. And it's a skin-colored lump as well. So usually the causes of this are people that are shaving a lot or even after waxing. And some people are more prone to them than others. And if you are prone to them, you should be using clippers to keep the vagina hair low instead of actually using a razor or something that's irritating or pulling out your skin of your vulva, because that's what's creating the ingrown hair. Now, the way that we treat these, it's pretty simple. Most of the time, just with warm compresses or again sitting in a warm bath of water for a few minutes. I tell my patients like 15 minutes a day, twice a day, you don't need to add anything to the water. Just sit in it. It helps draw out the hair that's stuck in there. Also, sometimes these little areas can get infected, so we might start you on a little antibiotic. And if it's big and inflamed, then again we do that incision and drainage where we open it up and drain it. But most of the time, I would say these ingrown hairs don't need that step. So another bump down there, kind of on the same lines as the ingrown hair, is something called folliculitis. And that's when each hair follicle actually becomes inflamed. And what happens is that the hair follicle is clogged and actually gets infected from bacteria. Again, can happen with shaving, waxing, or also if you're wearing really tight clothing and sweating and you kind of keep that moisture near the labia, this folliculitis or inflammation of your hair follicles can happen. Now, the way we treat this is antibiotics a lot of the time. And again, just cleaning that area properly, making sure you're getting good airflow there, not wearing tight clothes, not sitting in wet clothes, making sure you're showering like once or twice a day with soap and water to the area, and avoid the causes that I just mentioned. If you're shaving a lot, make sure that your razor is a clean razor, doesn't have a bunch of rust on it, is not really old. I would say you probably use the same razor maybe like one or two months and is stretching it and then change it out, especially if you're prone to folliculitis and this bacterial growth on the vulva. Now, these next two bumps down there are actually sexually transmitted diseases or STDs. So let's talk about them. Because this is what a lot of people come to my office, and if they have the normal lump down there, they're actually concerned that it's one of these two, um, and rightfully so. So the first one is something called a genital wart. Now, genital warts are from the HPV virus. So some HPV infects the cervix, which can lead to abnormal changes on the cervix. It's all the way deep in the vagina. Um, can also lead to cancer of the cervix if it goes unchecked for a long period of time. And there's another subset of HPV that actually causes warts on the labia and kind of on the mons, which is that top area above the vagina. So these appear as really soft kind of growths of tissue that have irregular edges to them. And they are skin colored. Sometimes they can be flat and sometimes they can be raised. They're usually not painful, and they usually are something that, you know, you're not born with it. Um, it's like I said, sexually transmitted and pops up, and you start to get one, then you might see two or three pop up in one area, four or five in another area, and that's usually a sign that it's genital warts. The cause, like I said, is the HPV virus. This is sexually transmitted. Now, the treatment's interesting because really it's your immune system that has to fight the virus in order for you to kind of be rid of the genital warts. So that can take one to two years for your body to actually fight the virus. A best way to prevent it is to get the HPV vaccine, which prevents some of the most common HPV types that can lead to genital warts. So keep that in mind. Now, the what we do is each time we see a wart or when it pops up, we remove it. There's different ways to remove it. We can use solutions or creams and can even cut them out or excise them out, depending on how big they are and what their location is. Now, removing it doesn't mean you're free of genital warts. New warts can pop up because the virus is still in your system for a few years. So we watch it closely, remove them when they pop up because the ones that are there, you know, means you're like a little bit more infectious, especially if it rubs on another partner's genitals. But you still have probably genital warts until you're a few months, maybe like six months to eight months free of even seeing a wart after removal, then most likely the virus is out of your system. Now, another lump down there is the herpes virus. So this is another sexually transmitted disease. Herpes um is something that's sort of for life, we say. You don't ever get rid of herpes. Your body doesn't fight it like the general warts and gets rid of it. You always have herpes once you get it. So the appearance, it kind of starts and changes its appearance. It starts as a cluster of little blisters that look almost like fluid-filled in one little spot or a few little spots across the vulva or near the vagina. And then those cysts kind of congeal or bl like mesh together and turn into an actual open sore that has a red border. So this initial appearance and then the change to this open sore is the appearance of the herpes virus. So what causes it? Again, sexually transmitted, it's from sex, it's an STD. There's nothing that we have on the market that prevents it. The best way to prevent it is to make sure you and your partner are getting tested and to use condoms to prevent any part of the genitalia from touching, because usually you get it from contact. So you just have to be really, really careful and make smart decisions when you're sexually active. The treatment, like I said, it's lifelong. But we have some medications that can suppress the virus and decrease how painful, because these can be really painful, decrease how long the pain lasts and how long you have the sores for, which are antiviral pills that you can take. Depending on if you want to take it every day or only when you have an outbreak, is up to a discussion that has to happen between you and your doctor. But I usually tell people it depends on how many outbreaks you get. The longer you have the virus, the least likely you are to get frequent outbreaks. So it depends on how many outbreaks you get, what kind of sexual partner are you in, like a committed relationship, or does the other partner also have herpes? Things like that kind of help guide which way we can give you the medication in order to, you know, just work for you and your lifestyle. But like I said, it's for life. And even if you're on the medication, you can still pass this virus to somebody else. So you should tell all sexual partners that you have herpes because they can potentially get it too. And that's it. That is the four vaginas only episode on the bumps down there. The bumps that you can get on the vagina and the vulva that are pretty common. And I love talking about this because I see this a lot in my office. And one, I want to put some people's minds at ease. Um, of course, if you have herpes or genital warts, you're gonna be a little bit more concerned. But anytime you see a lump or a bump on the vagina that you've never seen before, I urge you to go to your doctor to get it checked out to find out which one of these it might be. Because it's important to know for your current health, your future health, your sexual health, and things like that. So thank you guys so much for listening to Four Vaginas Only podcast. As usual, I appreciate each and every one of you. I am Dr. Celestine and I will see you in the next episode. Bye.