Feeling an unexpected lump in the vaginal area causes significant concern. The vagina is a muscular canal connecting the vulva to the cervix and uterus, and a lump felt within or near this structure can originate from several underlying tissues. The source could range from common, minor cysts to conditions requiring immediate intervention. Any new or persistent mass warrants a prompt consultation with a healthcare provider for an accurate diagnosis.
Causes Originating in Superficial Tissue
Many lumps felt near the vaginal opening originate from the glands or skin of the surrounding superficial tissue. The Bartholin’s glands, located on either side of the vaginal entrance, produce lubricating fluid. A blockage in the duct can lead to a fluid-filled sac called a Bartholin’s cyst, which feels like a small, soft mass. If the cyst becomes infected, it rapidly turns into a painful, warm, and swollen abscess that requires drainage.
Another common superficial cause is the vaginal inclusion cyst, which often forms after childbirth or trauma that traps surface skin cells beneath the lining. These are typically small, painless, and located on the lower, posterior wall of the vagina. Sebaceous cysts may also occur when oil-producing glands in the external skin become clogged, resulting in a small, dome-shaped lump. These masses are generally benign but must be definitively identified.
Benign Growths of Internal Structures
Lumps can also arise from deeper structures within the vaginal walls, the cervix, or the uterus. Gartner’s duct cysts develop from remnants of a duct present during embryonic development. These cysts are typically situated along the side walls of the vagina, are generally asymptomatic, and are often discovered incidentally during a routine pelvic exam.
Growths originating higher up, such as fibroids and polyps, may also present as a lump if they descend. Vaginal polyps are overgrowths of glandular tissue, sometimes found on a stalk, but often descend from the cervix. Uterine fibroids, or leiomyomas, are non-cancerous muscular tumors of the uterus. While rarely starting in the vagina, a pedunculated fibroid can protrude through the cervix and into the vaginal canal, creating a palpable mass. Endometriosis, where uterine lining-like tissue grows outside the uterus, can also infrequently form small, cyst-like nodules within the vaginal wall.
Lumps Caused by Organ Displacement (Prolapse)
A sensation of a lump or a bulge in the vagina is frequently caused not by a localized growth, but by the displacement of adjacent pelvic organs. This condition is known as Pelvic Organ Prolapse (POP), occurring when the pelvic floor muscles and supportive tissues weaken. Childbirth, aging, and chronic straining are significant risk factors. The resulting weakness allows organs to sag into the vaginal canal, creating a visible or palpable bulge.
The most common type is a cystocele, or bladder prolapse, which occurs when the bladder drops and pushes against the anterior wall of the vagina. A person with a cystocele may feel pressure or fullness, and often experiences urinary symptoms like a constant urge to urinate or difficulty emptying the bladder. Conversely, a rectocele happens when the rectum bulges against the posterior wall of the vagina. This type of prolapse is often associated with bowel symptoms, such as difficulty with defecation or the need to manually support the vaginal wall to pass stool.
Uterine prolapse involves the uterus descending into the vaginal canal, ranging from a mild drop to full protrusion outside the opening. Patients often describe the feeling as sitting on a ball or a general heaviness in the pelvis. The severity of prolapse is categorized in grades, with higher grades indicating a more significant descent of the organ.
When Immediate Medical Attention Is Necessary
While many vaginal lumps are benign, certain symptoms require immediate medical evaluation. Any lump that is rapidly growing, hard, fixed, or irregular in shape should be examined promptly, as these characteristics can be associated with malignancy. Persistent, unexplained bleeding, especially post-menopausal bleeding, or unusual discharge that is foul-smelling or blood-stained, are also serious warning signs.
Immediate attention is necessary if the lump is accompanied by severe pain, high fever, or signs of acute infection, such as rapidly increasing redness and swelling. The diagnostic process begins with a thorough medical history and a pelvic examination. Further steps may include imaging tests, such as an ultrasound or MRI, to characterize the mass. A biopsy, which involves taking a small tissue sample for laboratory analysis, is the only definitive way to rule out or confirm a diagnosis of cancer.