[Question #13987] Bump on partner’s inner labia
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1 months ago
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My partner discovered a painful, whitish bump on her inner labia. Small… like a tiny pimple… and it has what appears to be a pinprick dot (hole?) in the center. She woke up to this today. No significant or smelly discharge when I inspected.
I did have protected vaginal (about 8x) and unprotected oral sex (about 2x) with another woman in late Jan / early Feb. that woman hadn’t had sex for a couple of years. I’ve had no symptoms. This would be my only exposure to someone else in many years.
My partner does have a history of lichen sclerosis that she treats with cream. She’s also undergoing chemo (started in early-mid Mar). Also she’s had high risk HPV before that cleared in recent Paps.
1. Chance this is an STD? Could it be something latent surfacing now because of chemo immunosuppression?
2. If so, what? Given my lack of symptoms and safe practices, I’m guessing not gonnorhea, chlamydia, HIV, syphilis. Could it be trich, herpes or something else?
3. More likely an ingrown hair or cyst?
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Edward W. Hook M.D.
1 months ago
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Welcome back to our Forum and thanks for your continuing confidence in our service. I'll be glad to comment.
I would not worry that the lesion you describe is due to an STI- the timeline is wrong and the lesion you describe, both in terms of appearance and location does not suggest an STI. The lesion could be a benign cyst or a folliculitis lesion (even without a visible hair). Further, your casual partner sounds to be low risk. I would not worry and see no reason for STI testing for you. In light of her chemotherapy, if the lesion grows and becomes tender it would be a good ide for your partner to alert her doctor and have her/him take a look. EWH
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1 months ago
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Thanks. Very helpful. Not concerned and her bump healed. But since I get 2 more answers, I’ll use them!
I engaged with a CSW and felt comfortable given safe sex practices (unprotected oral both ways, condom vaginal). I know odds are low she has STIs based on other questions here.
However, I’m curious about 2 things:
1. The condom started to be less apparent as we had sex, so I figured it was slipping or rolling off. I withdrew and there was no condom on me. No idea if it came off inside her while having sex, but if so, I’d guess no more than a minute or so. She easily pulled the condom out and I put on a new one. From other posts, it sounds like this is still very low risk. A) is that accurate? and B) Why?
2. Trich seems to be a tough one to check for men. Could this incident have transmitted Trich? Given it often isn’t tested for and/or has no symptoms… how would the CSW even know? Odds I would get trich from this IF she was infected? (although I know she probably isn’t).
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Edward W. Hook M.D.
1 months ago
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1. You are correct. All things considered the encounter was low risk. FYI, condoms not uncommonly come off as the penis is removed. When this occurs, the end of the condom is readily accessible, often still hanging out of the vagina a bit. OTOH, when a condom comes off during sex it tends to be driven into the vagina where it is somewhat more difficult to retrieve.
2. Condoms protect against trich and trichomoniasis is rare in men. Trich can cause non-gonococcal urethritis in men. There are urine test tests that test for trichomoas as well as gonorrhea and chlamydia.
EWH
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1 months ago
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Thanks. Helpful again. Last ones!
How accurate are trich urine tests for men? What is the appropriate window to wait until testing? (FYI - I thought it was hard to test but saw online guidance that these tests are just lesser performed for men given more rarity, spontaneous clearance, lesser health risks, and possibly lower accuracy / sensitivity). I may get one for piece of mind even though I think I’d be shocked if positive.
Also, in my prior post, I was hoping to get any knowledge on single occurrence transmission rates (female to male) for unprotected vaginal sex (I.e., my worst case scenario)? Just wondering if it’s like other ones were even then the odds are like 20% or less (which if so, might make me forgo the test as then odds seem VERY unlikely as I’d presume she likely didn’t have trich in first place).
Thanks.
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Edward W. Hook M.D.
1 months ago
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Final responses
The urine trichomonas tests that I mentioned are amongst the most sensitive tests for trichomonas in men.
There are only limited data regarding the female to male transmission risk for various STI’s. Gonorrhea transmission is estimated to occur less than 20% of the time as you mentioned. Transmission of HIV occurs less than once in 2000 exposures. Other data for other STIs are not available although it is safe to say that there are no STI where the transmission right following female to male contact is more than 20 to 25%.
This completes this thread, which will now be closed. There should be no reason to return. I hope the information I have provided has been helpful. EWH.
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