[Question #3822] Desperately need advice.

34 months ago
Recap- had a condom break 2 months ago for 1 minute before changing it out with a new one. Today i went to the gyno to get a full STD panel and to schedule a PAP. In 2015 my PAP came back as ASCUS, but no HPV was detected. My gyno made me retest every 6 months & my last PAP was in 2016 with the same result of ASCUS but no HPV. At that point, my gyno said she wasn’t worried & to retest in 2-3 years. 
HOWEVER, I have had this finger-like projection on the inside of my right labia for at least 1-2 years. I noticed it when I first examined myself 1-2 years ago. It is one single finger-like projection that looks like a pearly papule or vestibular papillae. It is soft, can be moved back & forth and flesh colored. It has not gotten bigger over the years to my knowledge. On the left side of my labia minora, i seem to have a linear line going from the opening of the vagina to the top of the labia minora. It seems to have 2 finger-like projections and is soft & can be moved back and forth as well. Neither finger-like projections hurt or burn. My gyno examined me today & said that it looked like normal tissue to her & did not resemble typical HPV warts. She said that the right side of the labia minora with the single finger-like projection has one similarity with HPV warts, but even that was a stretch for her to say because it’s not a cluster and just a single finger-like projection. She said she would not worry and it looked more like normal tissue to her than anything. She offered to do a biopsy but said that was extreme & i should really think about it because she really didn’t think anything looked like HPV warts.

 1. I can’t decide if i should get the biopsy. On one hand, i want to be certain but then don’t want to put myself through that pain all because of my anxiety. What do you think i should do? 
2. I’ve seen plenty of gyno’s in the past 2 years- don’t u think they would have expressed their concerned if they thought it was HPV WARTS?
3. Does this sound like HPV warts?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
Welcome back to the forum, but sorry you found it necessary yet again. (More comments below.)

You describe a very typical case of vestibular papillomatosis. Such finger-like projections are entirely normal. Google "vestibular papillomatosis images" (or similar terms) to see many photos. Indeed your doctor would have said something if she thought they suggested genital warts. I see no need for a biopsy.

This is your 13th question on the forum in a little over a year, representing $325 in posting fees. Although I haven't read them all in detail, clearly you are obsessed with unwarranted fears of both herpes an HPV/warts, despite repeated science-based reassurance by all three forum moderators, and undoubtedly from your own doctors. Repeated questions on the same topics are discouraged, and it seems clear that our replies have not been effective in getting you past your fears. You might discuss all this with your personal physician, including discussion of a possible role for personal counseling. I suggest it from compassion, not criticism. In any case, we cease replying to such repeated questions, in which case the posting fee is not refunded. So let's make this your last one on HPV, herpes, etc. Thanks for your understanding.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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34 months ago
You’re right Dr. HHH, I need to be consulting with my therapist more, instead of posting on these forums. This will be my last post. I got a full STD panel and I’m waiting for my results. I’m praying everything comes back negative and it makes me upset thinking other bcuz i know I’ve used a condom with any person i had intercourse with (with the exception of the condom breaking for one minute). 

I found this bump on my the outside of the right labia minora, and I’m kind of freaking out. I found it in the shower. The bump is red and singular at the tip of the labia minora. I seemed to have popped it and yellow/white pus came out of it. Then i checked later tonight and there’s still a red bump there. It doesn’t itch or burn, but it can be kind of tender if i push on it or scrape against it. The bump appears to be hard at the tip of the labia minora. The labia skin is not broken. I tried to pop it a second time and clear stuff just came out of it. It’s still a singular red bump. 

1. Does this sound like herpes? 
2. Any advice for me while i await my test results? I’m so anxious. 
3. The previous HPV bump on the inside of my right labia that i mentioned in my original post- it seems to have 2 finger-like projections sticking out. It doesn’t itch, burn, hurt and is soft. Does this sound like an HPV wart? My doctor said she doesn’t think it’s an HPV wart and not to worry. But she said it did have a similarity with this one wart image she showed me on her computer. It looked the same as far as the finger like projections, but mine didn’t have clusters and she would have expected to see more by now if it’s been a few years with these. What do you think? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
33 months ago
1) For sure this is not herpes, which does not cause hard bumps from which white material can be expressed. It sounds like a garden variety enlarged sebaceous gland or pimple.

2) Do nothing and leave it alone.

3) I've already speculated that this sounds like normal vestibular papillomas, i.e. normal variations in labial/genital skin. Leave them alone as well. It also sounds like your doctor is confident they aren't warts, which is more reliable than anything I can say without seeing them in person (and we don't examine photos of skin lesions).

You need to stop examining your genital area so closely! Normal genital skin has innumerable variations in texture and contour, and can change as women age. (Same deal with men and their genitals.) I have a book titled "Genital Dermatology Atlas". As the name implies, it is filled with photos of genital skin conditions, both normal variations and actual abnormalities. Of its 300 pages, only 15 pages deal with all STDs. In other words, the very large majority of genital skin anomalies are not STDs. But those are the only things that ever enter your mind when you see something you don't understand. So my advice is that you completely stop ever looking at your genitals. 
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33 months ago
Dr. HHH- thank you for your advice! It has been helpful! I really appreciate you, and promise that i will not return after this post unless i need help with my test results. 

I checked the bump today and it was still there on the tip of my right labia minora. I went to the gyno and she said it did not look like herpes or an STD to her, but she did a culture to be assured. She said it looked like a clogged pore and it was a red bump. She prescribed me keflex so that it didn’t get infected because she poked & squeezed it while doing the culture which caused the bump to bleed a lil and have some drainage. I asked her if i should expect the culture to come back negative and she said that it didn’t look like herpes to her, but she can’t 100% say that without a culture. She told me not to worry and that she wouldn’t worry if it was her. 

I also had a full STD panel last week and everything came back negative. However, they didn’t test me for hsv 2 so i got the blood work done for that today. I am awaiting the culture and hsv 2 results, and am so anxious. I did have the stomach flu i think on Thursday & threw up and had body aches and chills but the next day i felt fine. I noticed the bump on Saturday. I don’t know if there’s a correlation there but i haven’t had sex for 2 months now and the last time was when the condom broke & i replaced it. 

1. If this bump was herpes, wouldn’t it have popped and turned into a sore by now? The gyno squeezed it really hard and all that came out was blood and some fluid. But it was still a bump. 

2. I am so worried this is herpes- it does not itch or burn, but it is tender if you touch it. However, i can get through the day without noticing it. What do you think it is? 

3. Is there any advice that you could give me to keep me calm while i await my culture & hsv 2 results? I’m so anxious. 

4. Does it still NOT sound like herpes to you? I know my gyno can’t ever say 100% anything but she said not to worry and that it didn’t look like herpes, but she did the culture for varification. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
33 months ago
1) Yes. Trust your gyn's opinion and advice, which are the same as mine.

2,4) It is not possible this is herpes.

3) Re-read all the replies in all your threads on this forum. If you continue to obsess about the possibility you have genital herpes (or HPV, for that matter), consider professional counseling. It is not normal to remain so anxious and fearful after all the evidence you have heard and the reasoned, science based reassurance you have had, from several sources.

That concludes this thread. And it really does have to be your last one. Any further questions along these lines will not receive replies. But I do hope the several discussions have been helpful to you.
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