Clitoral Hardness and Managing Dark Spots on Labia

Is there cartilage in the clitoris? How should a black mole on the vulvar mucosa be managed?

Is there cartilage inside the clitoris? A year ago, while taking a shower, I discovered a hard lump inside the clitoris (not visible externally) that felt like a small marble and could be moved slightly.
At that time, I consulted a family doctor (who only performed an external examination), and the doctor said he didn't know what it was, but as long as it didn't grow significantly in a short period or cause bleeding, I could observe it for now.
A year has passed, and there hasn't been much change, but a few days ago while showering, I noticed it seemed more prominent than before, although the size is about the same.

Q1: Is this normal tissue? Is it cartilage, or could it be a fibroma? My biggest concern is that it might be a tumor.
Additionally, a year ago, I also noticed light brown spots on my labia minora, and just a few days ago, I saw that the spots had darkened, resembling a black mole from a distance, but the borders are somewhat blurred, and the size is about 0.5 cm.
I also showed this to my family doctor, who said it was just pigmentation and that as long as it doesn't change significantly in the short term, it generally doesn't require attention.

Q2: However, I have heard that black moles on the mucosa of the labia minora should be removed.
Should I see a dermatologist or a gynecologist? I am worried it could be melanoma...

Danxinren, 20~29 year old female. Ask Date: 2017/12/24

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, I apologize for not being able to provide a diagnosis based on your description.
It could be a growth, as there is no cartilage in the clitoris.
If you continue to experience discomfort, I recommend seeing a gynecologist.
Wishing you good health.

Reply Date: 2017/12/24

More Info

When it comes to concerns about the body, especially regarding unusual findings in sensitive areas like the clitoris and labia, it's essential to approach the situation with both caution and informed understanding.

Understanding Clitoral Hardness
Firstly, regarding the hard lump you discovered inside the clitoris, it's important to note that the clitoris is a complex structure made up of erectile tissue, similar to that of the penis, and it does not contain cartilage. The sensation of a hard lump could be due to several benign conditions, such as a cyst or a fibroma. These are generally non-cancerous growths that can occur in various tissues of the body, including the genital area.
Your family doctor’s advice to monitor the lump for changes in size or bleeding is prudent. If the lump has remained stable in size and has not caused any discomfort or bleeding over the past year, it is likely benign. However, if you notice any changes, such as an increase in size, pain, or any other concerning symptoms, it would be wise to seek further evaluation, possibly through a gynecologist or a specialist in sexual health.

Managing Dark Spots on Labia
As for the dark spots on your labia, it is not uncommon for changes in pigmentation to occur in the genital area due to various factors, including hormonal changes, friction, or even benign skin conditions. The fact that the spots have changed color and size is worth noting, especially since you mentioned that they resemble a mole with irregular borders.
While your family doctor mentioned that this could be a case of pigmentary changes, it is essential to consider the possibility of more serious conditions, such as melanoma, especially if there is a change in color, size, or shape. The general rule of thumb for moles is the ABCDE criteria: Asymmetry, Border irregularity, Color variation, Diameter greater than 6mm, and Evolving size or shape. If your spot meets any of these criteria, it is advisable to have it evaluated by a dermatologist.

Next Steps
Given your concerns, I recommend the following steps:
1. Consult a Specialist: Since you have two separate concerns (the lump and the dark spots), it may be beneficial to see both a gynecologist for the clitoral lump and a dermatologist for the labial pigmentation. A gynecologist can provide a thorough examination of the clitoral area and may recommend imaging or biopsy if necessary. A dermatologist can assess the dark spots and determine if a biopsy is needed to rule out melanoma or other skin conditions.

2. Keep Monitoring: Continue to monitor both the lump and the dark spots. Document any changes in size, color, or sensation, as this information will be valuable for your healthcare providers.

3. Avoid Self-Diagnosis: While it’s natural to seek information online, avoid jumping to conclusions about your health. Professional evaluation is crucial for accurate diagnosis and treatment.

4. Maintain Open Communication: Be open with your healthcare providers about your concerns and any changes you observe. This will help them provide the best care possible.

In conclusion, while the findings you described may be benign, it is essential to remain vigilant and proactive about your health. Regular check-ups and consultations with specialists can help ensure that any potential issues are addressed promptly and effectively.

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