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Lumps on genitals in women
Cervix
The
main lump in the vagina is the cervix (neck of the womb).
This projects into the far end of the vagina and is about
3 cm across. You can usually feel the cervix by inserting
the first two fingers into the vagina and pushing upwards.
It is easier to feel if you ‘bear down’ (contract
your stomach muscles as if you are trying to open your bowels).
The texture of the cervix is similar to the end of your nose,
but it has a hole in the middle. In a woman who has not had
a child, the hole is about the size of a pencil lead, but
it is usually larger in women who have given birth. Menstrual
blood passes through this hole from the womb into the vagina.

The cervix
usually feels smooth, but sometimes pimples can be felt on
it. These are usually small glands called nabothian follicles,
and are normal.
However,
a pimple on the cervix could be a wart,
though it would be unusual to have warts on the cervix without
having any at the opening of the vagina.
A
small, soft lump which seems to be coming out of the hole in
the cervix is probably a cervical polyp. This is not cancerous,
but can bleed, especially after intercourse, so it is best
to have it removed.
Vagina
The
inside of the vagina can normally feel crinkly. This is because
it is designed to stretch for intercourse and childbirth,
so when it is not stretched the walls may have wrinkles.
However, it is not normal to have distinct small lumps in
the vagina. If you feel any, see your family doctor or go
to a genitourinary medicine clinic, because they could be
warts (though it is unusual to have vaginal warts without
any at the opening of the vagina.
Prolapse
A
bulge in the vagina is probably a prolapse. The vagina
rests between the bladder and the rectum (back passage);
the bladder
lies in front of it and the rectum lies behind. The bladder,
vagina, cervix and rectum are held in position by muscles
that stretch across the pelvis – the pelvic floor
muscles. If these muscles are weak, the bladder and/or
rectum can
lean towards the vagina and press on it, or the womb may
sag downwards.

Treatment for
prolapse is really surgery, but other measures may be of some
benefit.
- Lose
weight if you are obese. This will certainly help; excess
weight puts pressure on the pelvic floor and makes the problem
worse.
- Stop
smoking if you have a smokers cough; coughing puts pressure
on the pelvic floor.
- Do pelvic
floor exercises. They will help leakage of urine due
to prolapse.
- Surgery
is needed if prolapse is troublesome, particularly if it
is causing incontinence of urine. The surgeon cuts away flabby
parts of the vagina and strengthens the supporting tissues.
It is important to tell the surgeon if you are still sexually
active, so that the vagina is not made too narrow, or intercourse
may later be uncomfortable.
- A
pessary is a special ring placed in the vagina to give support.
Pessaries are made of plastic and are changed every 6 months.
They are usually used as a stop-gap measure while waiting
for an operation, or for women who cannot have surgery for
any reason.
Entrance to the vagina
In
many women, the entrance to the vagina normally feels
lumpy. This lumpiness is the remains of the hymen which
stretches across the entrance in young girls. The hymen
is a thin piece of tissue with a hole to let menstrual
blood flow out. The hole becomes enlarged during sports,
by inserting tampons and by sexual intercourse, but the
remnants of the hymen can remain as irregular, firm lumpiness.
A
woman who has given birth to a child, and who needed stitches
afterwards, may be left with a lumpy scar at the vaginal
opening.
Genital
warts (see section) are increasingly
common and often occur around the vaginal entrance.
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