Kinsey Confidential

Q: I started my monthly cycle three days ago, and on the second day, I noticed one small whitish bump on the labia minora. It is a simple bump, like a pimple, not a cauliflower-shaped lesion. It causes occasional discomfort when walking or sitting in particular positions. Is this an infected follicle or something brought on by menstruation? My boyfriend and I have been sexually active in the past but have not had such contact for several weeks.\nA: Thanks for your question and good for you for knowing -- and using -- such accurate terminology when talking about your genitals. It makes it much easier for us to understand what you're talking about when you describe a bump on your labia minora (the inner, often smaller, vaginal lips) rather than just "down there." \nBumps and lumps on the genitals can be caused by a variety of factors including an infected hair follicle, an in-grown hair or other bacterial infections or viruses, some of which might be sexually transmitted and others that are not sexually transmitted.\nConsider making an appointment with a health care provider while the bump is still there so that it can be examined. Warts caused by the human papillomavirus (HPV) are sometimes, but not always, cauliflower-shaped, and the only real way to identify what the bump might be is to check in with a health care provider, particularly because warts can appear weeks or even months after infection. While HPV warts themselves don't often cause pain, sometimes the particular place they happen to be situated at can cause discomfort.\nHPV is a challenging sexually transmitted infection for several reasons. First, there are more than 100 strains of this virus, a few of which can cause genital warts and a few of which can put a woman at increased risk for cervical problems (including cervical cancer). Fortunately, most women and men do not experience serious HPV-related problems, but it can still take an emotional toll on people as they deal with issues related to their health, treatment and learning to communicate about HPV infection with past, present and future partners.\nHPV is also challenging to deal with because we currently do not have a way to test men for HPV. If they were carrying a high-risk strain of HPV that is associated with risk of cervical changes in women, there would be no way to know. Further, even condoms cannot eliminate the risk of transmitting HPV between partners because HPV is a skin-to-skin transmitted infection, and neither male nor female condoms cover all of a person's genital skin.\nYou can, however, reduce your risk of HPV by abstaining from genital contact with a partner or limiting your number of sex partners. Within the next few years, a vaccine that is effective against some high-risk HPV strains might become available. In addition, although condom use cannot eliminate the risk of HPV, correct and consistent condom use is still associated with a greatly reduced risk of other infections and unintended pregnancy.\nFor more information about STIs, check out the KISISS Web site (www.indiana.edu/~kisiss). To learn more about vulvovaginal health including genital lumps and bumps, consider reading "The V Book: A Doctor's Guide to Complete Vulvovaginal Health" by Dr. Elizabeth Stewart.