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Monday, September 05, 2005

Boil on labia minora

Dr. Amy,

I am a 31 year old who is not sexually active, and who is slightly overweight. I sought the help
of my primary care physician because I repeatedly develop what my physican called a "boil or cyst" on my labia minora. They occur on the inner right side, though there have been occasions where they have occurred on the left side or on the outside of the labia minora. They are painful and slow to develop varying in size from a pea to as big as a large peanut m+m (encompassing 2/3 of the affected labia). When they drain, they develop a deep purple center. The drainage is a mixture of pus, old and new blood. My physician recommended a course of antibiotics and a referral to a gynecologist.

After examining the largest and most painful lump I have ever had, the gynecologist said I had nothing more than a pimple, which were quiet common in overweight women like me. She chalked their frequency up to hormones, told me NOT to take the antibotics, and
to return if I had any pain, redness, or swelling (all of which are why I was referred to
her in the first place).

Can this be nothing more than a pimple? Is medication necessary? Can hormones trigger these lumps? Should this problem be dismissed as a "fat" problem? Any information would be greatly appreciated.

Thank you,

Dear Shannon,

I have never heard of "pimples" on the labia minora. I guess it is possible to get them there just like you can get them anywhere else on the body, but I would be concerned that this is something else.

The first thing that comes to mind is Bartholin's cysts and abscesses. The Bartholin glands are located at the opening of the vagina (at the bottom of the labia minora), one gland on either side. The opening of a gland can get blocked and it will fill with fluid and swell. If it gets infected, it is extremely painful. It will drain pus when it opens. Once it heals over, the process often starts again because the opening is still blocked. The treatment (an office procedure) involves creating a new opening so that the fluid will be able to drain continuously.

I suspect that you need to find another gynecologist. In the meantime, it makes sense to take the antibiotics that your primary care physician recommended.

There are some gynecologists that specialize in the conditions of the vulva and vagina. If there is one in a major medical center near you, you might consider making an appointment with that person. Bartholin's cysts and abscessed can be diagnosed by any gynecologist, but only a specialist would be familiar with more unusual conditions.




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