Pain and Inflammation: Possible Causes of Vulvar Symptoms

Labial granuloma, sharp pain in the lower abdomen, lymphadenitis, suspected fungal infection?

Hello, doctor.
Since I have not engaged in sexual intercourse, I have visited the clinic three times without any improvement.
One day, I woke up to find that my labia minora were very painful.
Initially, I thought it was due to lying on my side, but later I noticed extreme pain in my lower left abdomen and also had a fever.
I consulted a doctor who mentioned that since I had not had sexual intercourse, it didn't seem like pelvic inflammatory disease.
I also had a urine test, which showed no signs of urethritis.
An abdominal ultrasound revealed no abnormalities in my ovaries or uterus.
The doctor prescribed antibiotics, but I still felt pressure on my labia minora when lying on my side (it was a dull pain, not sharp).
I suspect they might be slightly swollen.
While showering, I noticed some linear growths on my labia minora that resembled granulation tissue.
After researching, I found descriptions that closely match my symptoms: several linear, granulation-like bumps appeared on the inner side of my labia minora, matching its color.
After finishing the antibiotics, the swelling of my labia minora decreased, and the linear growths became less prominent.
However, I also discovered a protrusion in my lower left abdomen, which I suspect is "lymphadenitis" because the pain in my lower abdomen seems to be in that area.
One day, while commuting, I placed my suitcase on my thigh and began to feel discomfort in my lower right abdomen.
When I got home, I realized it seemed like there was also lymphadenitis in my lower right abdomen! Consequently, I started experiencing sharp pain in my lower right abdomen, along with inflammation and fever for the second time.
The previously reduced swelling of my labia minora became swollen again, and the linear protrusions reappeared! I also began to experience intermittent sharp pain in my labia minora, along with inflammation that extended to my back and legs.
Additionally, I noticed an increase in my discharge, which is yellow-green in color, leading me to suspect a fungal infection causing lymphadenitis.
I apologize for the lengthy message, but here is my summary if you are busy:
1.
Pain in the labia minora with linear granulation tissue, more swollen than before.
2.
Pain in the lower abdomen with a spherical protrusion, likely due to lymphadenitis, suggesting a gynecological bacterial infection.
3.
Increased yellow-green discharge, possibly indicating a fungal infection.
4.
Why does pressure on my abdomen cause inflammation on the right side? Is it due to my weakened immune system at that time?
5.
Why is there severe pain in my labia minora? Is this a fungal infection?
Thank you, doctor, for taking the time to address my concerns!

Mei you tou xu ~ gan xie yi shi!, 10~19 year old female. Ask Date: 2018/06/12

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I have not engaged in sexual intercourse, so I visited the clinic three times without any improvement.
One day, I woke up to find my labia minora very painful.
Initially, I thought it was due to lying on my side, but later I realized I had extreme pain in my lower left abdomen and also had a fever.
I consulted a doctor who said that since I had not had sexual intercourse, it did not seem to be pelvic inflammatory disease.
They tested my urine and found no signs of urethritis.
An abdominal ultrasound showed no abnormalities in my ovaries or uterus.
I was prescribed antibiotics.
Later, when lying on my side, I felt pressure on my labia minora (it was a dull pain, not sharp).
I suspected it might be slightly swollen.
While showering, I noticed some swelling in my labia minora, and there were linear growths resembling granulation tissue.
After researching, I found descriptions that matched my symptoms: several linear granulation-like bumps appeared on the inner side of my labia minora, the same color as the tissue itself.
After finishing the antibiotics, the swelling of my labia minora decreased, and the linear growths became less pronounced.
I also discovered a protrusion in my lower left abdomen, which I suspect is "lymphadenitis," as the pain in my lower abdomen seems to be in that area.
However, one day while commuting, I placed my suitcase on my thigh and began to feel discomfort in my lower right abdomen.
When I got home, I noticed that it seemed like there was also lymphadenitis in my lower right abdomen! Subsequently, I started experiencing sharp pain in my lower right abdomen, along with a feeling of inflammation and a second fever! The previously reduced swelling of my labia minora became swollen again, and the linear protrusions reappeared! I also began to feel intermittent sharp pain in my labia minora, along with inflammation that extended to my back and legs.
Additionally, I noticed an increase in my discharge, which was yellow-green in color, leading me to suspect a fungal infection causing lymphadenitis.
I apologize for the lengthy message, but here is my summary for the doctor:
1.
Sharp pain in the labia minora with linear granulation tissue, more swollen than before.
2.
Sharp pain in the lower abdomen with a spherical protrusion, likely due to lymphadenitis, suspected to be caused by a gynecological bacterial infection.
3.
Increased yellow-green discharge, possibly indicating a fungal infection.
4.
Why does pressure on the abdomen cause inflammation on the right side? Is it due to my weakened immune system at that time?
5.
Why is there severe sharp pain in the labia minora? Could this be a fungal infection?
Response from the doctor summarized as follows:
1.
The sharp pain in the labia minora with linear granulation tissue requires visual examination.
2.
The sharp pain in the lower abdomen with a spherical protrusion is not caused by lymphadenitis.
3.
The increased yellow-green discharge may indicate a fungal infection.
4.
Is the inflammation on the right side due to pressure? It is not necessarily due to a weakened immune system.
5.
Is the severe sharp pain in the labia minora possibly due to blisters or ulcers? It does not appear to be a fungal infection.

Reply Date: 2018/06/12

More Info

Understanding vulvar symptoms, particularly when accompanied by pain and inflammation, can be complex and multifactorial. Based on your description, it seems you are experiencing a combination of symptoms that may suggest an underlying infection or inflammatory condition. Let’s break down your concerns and explore possible causes and recommendations.

1. Vulvar Pain and Linear Growths: The pain in your labia minora, especially if it is sharp or stinging, could be due to several factors. The linear growths you describe may resemble skin tags or could be a manifestation of a condition such as vulvar vestibulitis or even a benign condition like a fibroepithelial polyp. The fact that these growths appeared after experiencing pain suggests that there may be some irritation or inflammation in the area.
2. Lower Abdominal Pain and Lymphadenopathy: The severe pain in your left lower abdomen, along with the sensation of a lump, raises the possibility of lymphadenopathy, which can occur due to infections. If the lymph nodes are swollen, it could indicate that your body is responding to an infection, possibly in the pelvic region. Given that you have experienced fever, this further supports the idea of an infectious process.

3. Increased Discharge: The change in your vaginal discharge to a yellow-green color is concerning for a potential infection, such as bacterial vaginosis or a sexually transmitted infection (STI) like trichomoniasis. While you mentioned that you have not engaged in sexual activity, it is still possible to contract certain infections through non-sexual means or through previous sexual encounters.

4. Possible Fungal Infection: You speculated about a fungal infection, which is a valid consideration, especially if you have experienced changes in discharge and irritation. Yeast infections can cause significant vulvar pain and discomfort, often accompanied by a thick, white discharge. However, the yellow-green discharge you described is more typical of a bacterial infection.

5. Impact of Pressure on the Abdomen: The discomfort you felt after placing pressure on your abdomen could be due to the existing inflammation or irritation in the area. When the immune system is compromised or when there is an ongoing infection, pressure on the abdomen can exacerbate pain or discomfort.

Recommendations:
- Follow-Up with a Specialist: Given the complexity of your symptoms, it is crucial to follow up with a gynecologist or a healthcare provider who specializes in women's health. They can perform a thorough examination, including a pelvic exam, and possibly take cultures of the discharge to identify any bacterial or fungal infections.

- Consider STI Testing: Even if you have not had sexual intercourse recently, it may be beneficial to undergo testing for STIs, as some can remain dormant or be transmitted in non-traditional ways.

- Monitor Symptoms: Keep track of any changes in your symptoms, including the nature of the pain, any new growths, changes in discharge, and any systemic symptoms like fever. This information will be valuable for your healthcare provider.

- Avoid Irritants: In the meantime, avoid any potential irritants such as scented soaps, douches, or tight clothing that may exacerbate your symptoms.

- Hydration and Nutrition: Ensure you are well-hydrated and maintain a balanced diet to support your immune system, especially if you suspect an infection.

In conclusion, while your symptoms may suggest a possible infection or inflammatory condition, a definitive diagnosis can only be made through a clinical evaluation. It is essential to seek medical attention to address your concerns comprehensively and to receive appropriate treatment.

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