Cervix
The main lump in the vagina is the cervix (neck of the womb). This projects into the far end of the vagina and is about 3 cm across. You can usually feel the cervix by inserting the first two fingers into the vagina and pushing upwards. It is easier to feel if you ‘bear down’ (contract your stomach muscles as if you are trying to open your bowels). The texture of the cervix is similar to the end of your nose, but it has a hole in the middle. In a woman who has not had a child, the hole is about the size of a pencil lead, but it is usually larger in women who have given birth. Menstrual blood passes through this hole from the womb into the vagina during a period.
The cervix usually feels smooth, but sometimes pimples can be felt on it. These are usually small glands called nabothian follicles, and are normal.
However, a pimple on the cervix could be a wart, though it would be unusual to have warts on the cervix without having any at the opening of the vagina.
A small, soft lump which seems to be coming out of the hole in the cervix is probably a cervical polyp. This is not cancerous, but can bleed, especially after intercourse, so it is best to have it removed.
Vagina
The inside of the vagina can normally feel crinkly. This is because it is designed to stretch for intercourse and childbirth, so when it is not stretched the walls may have wrinkles. However, it is not normal to have distinct small lumps in the vagina. If you feel any, see your family doctor or go to a genitourinary medicine clinic, because they could be warts (though it is unusual to have vaginal warts without any at the opening of the vagina.
Prolapse
A bulge in the vagina is probably a prolapse. The vagina rests between the bladder and the rectum (back passage); the bladder lies in front of it and the rectum lies behind. The bladder, vagina, cervix and rectum are held in position by muscles that stretch across the pelvis – the pelvic floor muscles. If these muscles are weak, the bladder and/or rectum can lean towards the vagina and press on it, or the womb may sag downwards.
Treatment for Prolapse
- Lose weight if you are obese. This can help as excess weight puts pressure on the pelvic floor and makes the problem worse.
- Stop smoking if you have a smokers cough as coughing puts pressure on the pelvic floor.
- Do pelvic floor exercises. They will help leakage of urine due to prolapse. You may benefit from using the Squeezy app, using online resources to learn the correct ‘Kegel’ technique, or require referral to a Women’s Health Physiotherapist for assessment and advice.
- A pessary is a special device, usually a firm rubbery ring placed inside the vagina to give support. Pessaries are made of plastic and are changed every 6 months. They may be very helpful, or used as a stop-gap measure while waiting for an operation, or for women who cannot have surgery for any reason.
- Surgery is needed if prolapse is troublesome, particularly if it is causing incontinence of urine. There are various different procedures which can be done to lift the bladder neck, support the uterus, or strengthen the front and back walls of the vagina. Sometimes a hysterectomy can be done to remove the uterus (womb) entirely.
Entrance to the Vagina (Vulva)
In many women, the entrance to the vagina normally feels lumpy. This lumpiness is the remains of the hymen which stretches across the entrance in young girls. The hymen is a thin piece of tissue with a hole to let menstrual blood flow out. The hole becomes enlarged during sports, by inserting tampons and by sexual intercourse, but the remnants of the hymen can remain as irregular, firm lumpiness.
A woman who has given birth to a child, and who needed stitches afterwards, may be left with a lumpy scar at the vaginal opening.
Genital warts are an increasingly common sexually transmitted infection and often occur around the vaginal entrance or the back passage. If you suspect you have a wart, you should visit a genitourinary medicine (GUM) clinic for testing and treatment.
Very rarely, a lump at the entrance to the vagina is cancerous (vulval cancer). It may just be a lump (often shaped like a mini-cauliflower), or there may also be itching, bleeding and an unpleasant smell. Therefore, if you have a lump that increases in size, ask your doctor to check.
First published on: embarrassingproblems.com
Reviewed and edited by: Dr Laura Gush
Last updated: May 2021
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