A Bump

[DLEAR]

Recently I discovered a bump under the skin of my labia majora.  It was tender to the touch with a small pea sized top and a sort of extention down from the top, rather deep in the tissue.  It appeared overnight, after a long sexual encounter with my boyfriend.  That night, I was able to squeeze some creamy substance out of it, just like a pimple, and some bleeding followed.  Now it feels fine, much less tender, very little evidence of it remains.  It doesn't seem consistent with anything I have read about herpes, not red, only one, not a clear fluid filled sac, no burning, tingling, or itching, not sure about flulike symptoms, just got over the flu and have frequent headaches normally, no lymph node swelling, and no crusty top.  Should I still consider getting this looked at or see what happens.  My boyfriend and I have never had a STD, and if this is one, I don't know when I got it or how and do not want to infect him.  I get frequent testing done, never for herpes, nothing positive.
What do you think?

[H. Hunter Handsfield, M.D.]

It sounds most like a pimple or folliculitis, i.e. hair follicle infection, probably unrelated to sex the night before (except for the possibility that massaging/rubbing the area could have made a preexisting swelling more prominent).  If you mean labia minor rather than major--i.e., near the vaginal opening--it might be an infected Bartholin gland duct.  The latter is often due to chlamydia or GC; the former is not likely to be sexually transmitted.  I agree it doesn't sound like herpes.

Whether you are at risk for STD depends on other recent partnerships, how long you and your boyfriend have been together, etc.  Assuming it's a longstanding and committed relationship, that in itself is strong evidence against STD.  But if otherwise, it might not be a bad idea to get retested for chlamydia and gonorrhea.

The standard advice applies:  if the problem persists, worsens or recurs, see you health care provider.

Good luck--   HHH, MD

[DLEAR]

Just to clarify, the bump was on the inner labial wall, bump started yesterday morning, mostly resolved this morning.

[H. Hunter Handsfield, M.D.]

Then maybe it was a Bartholin duct infection.  Not all cases are sexually acquired, but probably a good idea to have another round of gonorrhea/chlamydia testing.  Also speak with your partner about any symptoms he might be having, especially urethral discharge or painful urination.

HHH, MD