Swelling Around the Vaginal Region (Vulva)

Swelling around the vaginal region (vulva) may involve the vaginal lips, labia minora, or the labia majora. There are myriad causes of such swelling that can often be easily differentiated based on location, appearance, and other concomitant symptoms.

Swelling in the vulvar region may be generalized or may be confined to one or more structures. It may be unilateral or bilateral. The causes are variable depending on the specific presentation. Localized swelling could be due to cysts, abscesses, or hernia. Generalized swelling is more likely due to infectious, edematous, or allergic causes.

Vaginal swelling may require immediate medical condition. Patients who experience vagina swelling and other associated symptoms like severe pain and/or tenderness, high fever, and bleeding should seek immediate medical care. These other symptoms might develop after the swelling.

Seek immediate medical attention if you experience:

  1. Severe swelling
  2. Severe pain/tenderness
  3. High fever
  4. Bleeding
  5. You feel it is necessary

Swelling in the vulvar region is a symptom, so management depends upon its cause. If the cause is an allergic reaction or chemical irritation, then it's best to avoid that substance. Treatment for infectious conditions is a specific antimicrobial agent that depends on the causative microorganism. Surgery is the only definitive treatment in cases like cystic swellings and hernia. However, it may be delayed or avoided if the swelling is determined to be innocuous with a low risk of complications.

Table: Common causes of Swollen Vagina / Swollen Labia Minora / Swollen Vaginal Lips

Cause

Comments

Edema

Due to reduced venous or lymphatic drainage. Numerous causes

Allergy and Irritation

Allergic reaction or irritation to chemicals or latex

Cellulitis

Bacterial skin infection

Vulvovaginitis

Inflammation of vulva and vagina. Usually due to infection.

Cervicitis

Inflammation of the cervix

Bartholin's Cyst

Cystic swelling due to blocked Bartholin's gland

Gartner's duct cysts

Cyst in the sidewalls of the vagina.

Vaginal Inclusion Cyst

May occur after injury to vaginal wall, e.g. During childbirth.

Trauma

Straddle Injuries, Rough sexual intercourse

Pregnancy

Enlarging uterus puts pressure on the blood vessels in pelvis, reducing venous return

Hernia

Generally unilateral and swelling reducible.

Vulvar Abscess

Develops after simple infections in skin or layers below it.

Hypertrophy of Labia Minora

Enlarged labia minora, probably normal

Edematous swelling is a generalized swelling around the vagina that is usually present on both sides. The skin may show some changes if it's been swollen for an extended period of time. Edematous swelling is often either due to poor lymphatic drainage or venous drainage of the region. There are numerous causes of this poor drainage. Poor venous drainage may occur in pregnancy due to pressure of enlarging uterus on the veins in the pelvis.

Local allergic reaction could also give rise to generalized vaginal swelling. Usually the allergic reaction is in response to any chemical applied locally, such as soaps, bubble baths, vaginal contraceptives, sprays, lubricants, creams etc. Allergic reaction to latex (condoms) might also result in vaginal swelling after sexual intercourse. Chemical irritation from the aforementioned chemicals, without an allergic reaction, may also result in swelling in the vulvar region. This condition is referred to as irritant contact dermatitis, and the previously mentioned condition is called allergic contact dermatitis.

Infections are a significant cause of vaginal swelling. Inflammation of the vagina and cervix, known as vulvovaginitis and cervicitis respectively, often result in swollen vaginal lips. However, one or more other concomitant symptoms usually present as the main symptoms. Skin infections like cellulitis may also result in swollen vulva and often in severe pain. These infections may later form a vulvar abscess if not treated completely.

Bartholin's gland is located posterior to the vaginal opening on both sides. Sometimes blockage of this gland gives rise to cystic swelling. This is referred to as Bartholin's cyst. The fluid inside the cyst may occasionally get infected, resulting in a Bartholin's abscess. Similar cysts may also develop in a structure known as Gartner's duct, which generally disappears after birth, but in rare cases may persist. Another common cystic swelling is the vaginal inclusion cyst.

Vaginal swelling after straddle injuries need to be thoroughly evaluated, especially if associated with other symptoms including severe pain, blood in the urine, etc. One may determine this based on the severity of the injury, whether it's mild or requires urgent medical attention. Swelling of the vaginal lips may also occur after rough sexual intercourse, which usually resolves itself.

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