Painful Fluid-Filled Cysts in the Vulva – Symptoms and Treatment of Vulvar Endometriosis

Painful Fluid-Filled Cysts in the Vulva – Symptoms and Treatment of Vulvar Endometriosis

Is sexual intercourse becoming painful for you day by day? Do you experience discomfort when passing stool? Some of the conditions are so complex and rare that regardless of how cautious you are about your health, it can occur and hamper your lifestyle.

In terms of women, there are several gynecological disorders that are common and they are quite aware of most of them. But some of the rare conditions such as endometriosis of the vulva can befall on anyone and often need only surgical intervention to treat it effectively. We will discuss this uncommon condition in this review.

Vulvar Endometriosis

The medical term endometriosis is often referred to a condition when endometrial tissue grow out of its actual place i.e. uterus to other organs such as ovaries, bladder, cervix and in some cases, vagina or vulvar region. Endometrial lining is an important part of women menstrual cycle. It sheds blood during monthly periods.

In endometriosis, this tissue grows out of place and it finds no way to leave the body. Over the time, the displaced tissue becomes trapped and can form cysts that results in pelvic pain and other symptoms. Though endometriosis of the vulva rarely occurs, but when it happens, it’s a very painful condition that sometimes required immediate medical attention.

In vulvar endometriosis, fluid filled cysts are formed. These cysts contain gelatin-like material or may contain blood in some cases. In medical terminology, these cysts are also known as endometrioma. When there are large endometrioma, it can be extremely painful, often before menstruation.

What vulvar endometrioma looks like?

Vulvar endometrioma can be reddish to bluish and purple in color. It may feel tender on touch. In some cases of vulvar mass, the cyst when ruptured during the operation, chocolate colored fluid came out. The cysts can fluctuate in size as well.

What causes Vulvar Endometriosis?

Since the cause of endometriosis, a common disorder affecting 176 million women worldwide is not known, set aside the question decoding the cause of vulvar endometriosis. Yet, most medical experts agree that it can trigger due to increased level of estrogen hormone. Other factors that might lead to vulvar endometriosis are:

  • Menstrual blood flowing back into the pelvic cavity (Retrogade menstruation)
  • Never being pregnant
  • Abnormalities in uterus
  • Family history of endometriosis
  • Scarring formed after surgical operation such as c-section or hysterectomy
  • Abnormal change of endometrial tissue (metaplasia)
  • Immune system dysfunctions
  • Environmental toxins

Symptoms of Vulvar Endometriosis

Similar to endometrioma of other organs of the pelvis, endometriosis of the vulva may or may not cause any symptoms. Endometriosis may manifest itself in various forms and in women with vulvar endometriosis; pain during sex is a classic symptom. Other symptoms might include:

  • Nausea
  • Painful urination
  • Pelvic pain before or after periods
  • Irregular periods
  • Discomfort in passing stool or diarrhea

In some as mentioned above, symptoms might not occur until conditions such as infertility is diagnosed.

Vulvar Endometriosis and Infertility

Impact of vulvar endometriosis on fertility of a woman is not known. However, since the condition affects the reproductive organs of a woman and symptoms such as painful sex might prevent her from becoming pregnant.

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Diagnosis of Vulvar Endometriomas

Like other types of endometriosis, vulvar endometriosis can be diagnosed from location of pain and other symptoms. The doctor typically goes through following procedures:

  1. Pelvic examination – The doctor will manually insert two gloved fingers in the vagina and check for cysts. Smaller areas of vulvar endometriosis can’t be felt but larger ones can be found.
  2. Transvaginal Ultrasound – In this procedure, high frequency sound waves are produced to create visual images of the internal organs. For this, the doctor will insert an instrument called transducer that emits sound waves to display images on a monitor.
  3. Laparoscopy or Biopsy – Though preliminary diagnoses of vulvar endometriomas can be done during pelvic examination, but to accurately diagnose the condition, the doctor may consider laparoscopy. That is why this procedure is known as gold standard when it comes to diagnosing endometriosis. The doctor or pathologist will extract a sample endometrial tissue using a lighted scope and lab test in order to arrive at a conclusion.

This procedure can exactly pinpoint the location and size of cysts. The biopsy might also be necessary to rule out vulvar or vaginal cancer.

How Vulvar Endometrios is treated?

After diagnosing the condition, the endometrioma or cysts has to be surgically removed. A local anesthesia is used before performing the operation. The doctor might also recommend pain relievers such as ibuprofen, and naproxen for getting relief from pain.

Oral contraceptives or shots may also be on the list of options. These hormonal pills shrink endometriosis by preventing ovulation. These medications might induce side effects so consult the doctor and make sure you are in a position to take these pills.

Though endometriosis is a common condition in women, vulvar endometriosis rarely occurs. But even to prevent these rare cases, you should go through regular pelvic examination to remain on a safe side.