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Experiencing dull ache and pain around labia majora. Hardened area around vaginal area. Underlying cause?

Mar 2013
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I am experiencing a dull ache and pain around my labia majora, it appears slightly swollen and on inspecting it, it feels like there is a large hardened area all around the lower part of the majora to the opening of the vagina, I initially started with thrush like symptoms. My glands in the right side of my groin are raised and are also quite painful to touch. I have not had sexual intercourse for 5 days. The symptoms started 2 days ago. It is painful to walk and touch. There is no rash or visible lumps. Can you help me?
Posted Wed, 26 Jun 2013 in Women's Health
Answered by Dr. Aarti Abraham 12 minutes later
Thanks for your query.
Swelling Around the Vaginal Region (Vulva)

There are myriad causes of swelling over the labia majora, and the exact diagnosis can be confirmed ONLY by a gynaecologist after having a look at it, and appropriate testing.

Localized swelling could be due to cysts, abscesses, or hernia. Generalized swelling is more likely due to infectious, edematous, or allergic causes.

If the cause is an allergic reaction or chemical irritation, then it's best to avoid that substance. Treatment for infectious conditions is a specific antimicrobial agent that depends on the causative microorganism. Surgery is the only definitive treatment in cases like cystic swellings and hernia, or an abscess resulting from an infection.

Herein I would enumerate the common causes of swollen labia majora :

1. Edema - Due to reduced venous or lymphatic drainage.
2. Allergic reaction or irritation to chemicals or latex
3. Cellulitis
4. Bacterial skin infection - Vulvovaginitis, which is Inflammation of vulva and vagina. Usually due to infection.
5.Bartholin's Cyst - a Cystic swelling due to blocked Bartholin's gland
6. Gartner's duct cysts - Cyst in the sidewalls of the vagina.
7. Vaginal Inclusion Cyst - May occur after injury to vaginal wall, e.g. During childbirth.
8. Trauma - due to Straddle Injuries, Rough sexual intercourse
9. Pregnancy - where the enlarging uterus puts pressure on the blood vessels in pelvis, reducing venous return
10. Hernia - it is generally unilateral and swelling reducible.
11. Vulvar Abscess - Develops after simple infections in skin or layers below it.

Edematous swelling is a generalized swelling around the vagina that is usually present on both sides. The skin may show some changes if it's been swollen for an extended period of time. Edematous swelling is often either due to poor lymphatic drainage or venous drainage of the region. There are numerous causes of this poor drainage.Given the enlarged glands in the groin, this could be a reason for your problem. Infections again are implicated in enlargement of glands and reduced lymphatic drainage. Various STDs can cause this.

Local allergic reaction could also give rise to generalized vaginal swelling. Usually the allergic reaction is in response to any chemical applied locally, such as soaps, bubble baths, vaginal contraceptives, sprays, lubricants, creams etc. Allergic reaction to latex (condoms) might also result in vaginal swelling after sexual intercourse. Chemical irritation from the aforementioned chemicals, without an allergic reaction, may also result in swelling in the vulvar region. This condition is referred to as irritant contact dermatitis, and the previously mentioned condition is called allergic contact dermatitis.

Infections are a significant cause of vaginal swelling. Inflammation of the vagina and cervix, known as vulvovaginitis and cervicitis respectively, often result in swollen vaginal lips. However, one or more other concomitant symptoms usually present as the main symptoms. Skin infections like cellulitis may also result in swollen vulva and often in severe pain. These infections may later form a vulvar abscess if not treated completely.

Bartholin's gland is located posterior to the vaginal opening on both sides. Sometimes blockage of this gland gives rise to cystic swelling. This is referred to as Bartholin's cyst. The fluid inside the cyst may occasionally get infected, resulting in a Bartholin's abscess. Similar cysts may also develop in a structure known as Gartner's duct, which generally disappears after birth, but in rare cases may persist. Another common cystic swelling is the vaginal inclusion cyst.

Vaginal swelling after straddle injuries need to be thoroughly evaluated, especially if associated with other symptoms including severe pain, blood in the urine, etc. Swelling of the vaginal lips may also occur after rough sexual intercourse, which usually resolves itself.

Having had this overview , here are a few pointers -
1. Have protected sex, preferably no sex till you see a doctor and confirm the diagnosis.
2. Avoid touching, rubbing, overcleaning the area.
3. Wear loose, cotton, allergen free underpants, and avoid prolonged dampness in the area.
4. Do not use any kind of OTC medication till the diagnosis is confirmed.
5. Since you started out with thrush, check yourself for STDs and check your blood sugars, both of which predispose to thrush.

Take care.
Feel free to discuss further.

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