While a vulvar or vaginal lump can be a symptom of cancer, it’s usually caused by less serious conditions. Vulva and vaginal cancer are fairly rare, so if you have a pubic lump, it’s likely caused by something else.
Lumps and bumps in your vulvovaginal area can be concerning — but they’re often benign. Many vulvar lumps are benign and can result from infections, cysts, or other noncancerous conditions.
However, a healthcare professional should evaluate any new, persistent, or changing lump to rule out serious conditions, including cancer.
For those who aren’t medical professionals, it’s not easy to determine whether a vulvovaginal lump is cancerous just by looking at it.
The following characteristics may help you narrow down the potential cause.
Location
- Cancerous lumps can form anywhere on the vulva or vagina, including deeper inside the vaginal canal.
- Lumps near the opening of the vagina may be Bartholin cysts, which can become infected.
Texture and shape
- Rough clusters of closely-spaced lesions, which may resemble a cauliflower, can be genital warts. These are caused by the human papillomavirus (HPV).
- Blister-like lesions can be caused by genital herpes, which is caused by the herpes simplex virus (HSV).
- Smooth patches can be caused by lichen sclerosis.
- Cancerous lumps tend to be hard and irregularly shaped.
Color
- Skin-colored bumps may be genital warts.
- White or light-colored patches could be lichen sclerosis.
- Small white or yellow-white bumps may be Fordyce spots, which are painless and harmless.
- Red or darker lumps could indicate an infected cyst or ingrown hair.
- Discolored patches may be caused by cancer.
Persistence
- Lesions that come and go without treatment could be genital herpes, boils, pimples, ingrown pubic hair, or benign cysts.
- Vulvovaginal lumps tend to be persistent — they don’t go away on their own.
- However, persistent lumps and bumps can also be skin tags or Fordyce spots.
Sensation
- Infected cysts (including benign cysts, like ingrown hairs or Bartholin cysts) tend to be warm or hot to the touch.
- Painful lumps may be cancerous, but they may also be due to infected cysts.
In addition to lumps, vulvar and vaginal cancers can have other symptoms, including:
- bleeding (that isn’t menstruation)
- changes in skin color, thickness, or texture
- discharge that is abnormal in smell or color
- itching or burning in the vulvar area
- pain during penetration
- painful or frequent urination
Advanced vulvovaginal cancer — that is, when the cancer has spread to nearby tissues — can lead to the following symptoms:
- constipation
- pain in the pelvis, back, or abdominal area
- swelling in the legs
While these symptoms don’t automatically mean you have cancer, it’s a good idea to see a healthcare professional if you have one or more symptoms.
Even if you don’t have cancer, another underlying medical condition may cause these symptoms, and you might require treatment.
If you discover a lump, it’s important to monitor it for any changes.
You should contact a healthcare professional if:
- The lump persists for more than a few weeks
- It grows in size or changes in appearance
- You experience other symptoms like pain, itching, or unusual discharge
- You have risk factors for developing vulvovaginal cancer
The risk factors for vulvovaginal cancer include:
- being 55 or older
- having a history of cancer
- having a history of HPV or genital warts
- having a family history of vulvovaginal cancer
- smoking cigarettes
- having vulvar intraepithelial neoplasia (VIN)
- having HIV
- having a skin condition that can affect the vulva, such as lichen planus
When you see a healthcare professional, they may perform several tests to determine the cause of the lump.
These tests can include:
- a pelvic exam, which is a physical examination of the vulvar area
- a Pap smear, which can check for abnormal cells in your vaginal area.
- a colposcopy, which is where a healthcare professional uses a colposcope to examine the vaginal walls and cervix
- a biopsy, where they take a sample of your cells to see if the cells are cancerous
If the healthcare professional thinks your lumps may be caused by an STI, they might order blood or urine tests to determine the cause.
While a vaginal lump can be a sign of vulvovaginal cancer, it’s more likely to be due to noncancerous conditions. However, it’s essential to consult a healthcare professional for an accurate diagnosis.
Vulvovaginal cancer is typically treatable if diagnosed early. Your treatment options could include surgery, radiation therapy, and chemotherapy, depending on the stage and type of cancer. Early detection improves your chances of survival.
Sian Ferguson is a freelance health and cannabis writer based in Cape Town, South Africa. She’s passionate about empowering readers to take care of their mental and physical health through science-based, empathetically delivered information.
