Secret Sex Questions Answered


Even the boldest among us have trouble asking the doctor certain questions. Here are a few that make most women blush -- with answers from the experts.
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You won't know unless you ask

I found a lump on my vagina. What could it be?

There are many things that can cause lumps on the vagina and the vulva, the outer genital area, says Stuart Fischbein, M.D., a Los Angeles-based ob/gyn. One common kind of lump, really a pimple-like cyst, forms when a sebaceous skin gland becomes clogged. If it's not bothersome, you can let it be, but if it's a source of discomfort, your doctor can drain it. A cyst also can form when a Bartholin's gland, which produces a natural sexual lubricant and is found at the base of the vagina, gets blocked. These cysts can grow as large as a peach and often get infected, so they are usually opened, drained and treated with antibiotics. Generally, an inclusion cyst occurs after childbirth when a piece of skin gets buried after an episiotomy, an incision made to ease delivery of the baby. The buried skin continues to produce cells, creating a lump, which can be excised in a simple procedure.

Genital warts, which are caused by the human papilloma virus (HPV), are another possibility. (Although HPV is a sexually transmitted disease that's been linked to the development of cervical cancer, there are many different strains of HPV, and just because you have warts does not necessarily mean you have cancer.) The warts appear singly or in clusters, with individual warts sometimes as small as a pencil tip. They're usually painless but can cause itching, discomfort and burning. Although warts can be removed by surgery, lasers, freezing or with a topical drug called podophyllin, they tend to recur and may need to be treated more than once. A powerful cream called Aldara, which appears to boost skin's natural defenses, can also help clear the lesions.

Cancerous tumors on the vulva and vagina, which can be seen and felt as lumps near the opening of the vagina, are rare but becoming increasingly common among women under 40. Typically very obvious in the early stages, these tumors are sometimes accompanied by discoloration or an itchy, scaly patch. In addition, "More than ninety-five percent of women with vulvar cancer have had symptoms months to years before they were diagnosed," says R. Allen Lawhead, M.D., director of gynecologic oncology at Atlanta Medical Center.

I've always had small, white bumps on my nipples. What are they?

Small white bumps on the areola are perfectly natural and quite common. These bumps, called Montgomery glands, produce a lubricant that helps keep the nipple soft, making breast-feeding more comfortable for mothers and their babies, says Laura Morris, M.D., M.B.A., F.A.C.S., a breast surgeon at Cancer Treatment Centers of America, in Goshen, Indiana. Sometimes these glands become clogged or enlarged -- even when a woman is not nursing -- but the problem usually resolves itself. "You don't need antibiotics or surgery," says Morris. "And even if they stay enlarged after pregnancy, there's nothing to worry about."

Continued on page 2:  Vaginoplasty; pap smears

 

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