it could be a zit, gross but true. I would see a doctor if you are concerned.

Something you should see someone about, not sitting around on it waiting for it to get worse while other people on the internet um and ahh about your situation.

Yes thank you that was so helpfull. I KNOW I have to go to the doctor, I just wanted some ideas as to what it MIGHT be.

[Painful perineum in all its forms. Contribution of manual medicine and osteopathy. Clinical study.] Abstract Text: No satisfactory therapy has yet been found to relieve many chronic pelviperineal pains such as Dyspareunia, Vulvodynia, Coccygodynia and others pelvic various pains, although these can be highly disruptive in everyday life. They may be brought on by an osteo-myo-fascial disorder, often undetected despite the possibility to effectively treat, this condition using manual medicine in the gynaecologist's office. A framed clinical examination protocol as well as a therapeutic one are offered in this novel approach still rarely implemented in gynaecology. Such treatment is documented in six typical clinical cases and a global study on 86 patients with disruptive chronic pelviperineal pain, showing 71% satisfactory results following two manual medicine sessions. These very encouraging results need to be confirmed on a larger scale in order to establish an appropriate teaching protocol. Perineal pain. 10 common causes of Perineal pain. Bacterial prostatitis is a bacterial inflammation of the prostate gland, in men Tear in the anal region. Group of multiple boils. Bladder infection or inflammation Duplication of a part of the digestive system. Duplication of the anal canal is the least common where as duplication of the Symptoms vary depending on what part of the digestive system is duplicated Generalized pain in the vulvar region which can occur intermittently or constantly and has no obvious cause. The pain may be triggered by activities that put pressure on the area such as bike riding, tight clothes or even intercourse Common sexually transmitted disease often without symptoms Granulomatous prostatitis is an unusual benign inflammatory process of the prostate. Clinically, it mimics prostatic carcinoma, thus requiring pathological examination for diagnosis Swollen blood vessels around the anus. Any damage inflicted in the body. An episiotomy is a surgical incision into the perineum, the area between the bottom of the vaginal opening and the anus, in order to increase the size of the vaginal opening during childbirth. If it is done as part of gynecologic surgery, it's called a perineorrhaphy. As discussed in recent threads on this forum, episiotomy is controversial. However, it's sometimes necessary, and, in any event, sometimes a tear (also called a perineal laceration) will occur during childbirth regardless of whether an episiotomy is cut. After an episiotomy or tear, the doctor or midwife should inspect the vagina, cervix, perineum, and anus to make sure there are no other damaged areas. If pain is a problem, the area should be injected with novocaine, or, if necessary, the patient should be offered an IV shot of strong painkillers. In some cases a large tear of the cervix and/or vagina requires repair under epidural or general anesthesia in the operating room. Most women, however, have a 2nd-degree tear of the vagina, which can be repaired right in the delivery room. A 1st-degree tear is a thin line through the perineal tissue. This is less common than a 2nd-degree tear, which goes a little deeper. 3rd-degree tears actually cut into or through the round sphincter muscle that surrounds the anus. This muscle helps "hold it in" so identification and repair of injuries to this muscle may prevent fecal incontinence. A 4th-degree tear goes into the rectal tissue, and must be repaired correctly to prevent a hole forming between the vagina and rectum, called a fistula, where gas and feces can pass into the vagina. I have seen women who delivered at home or in an otherwise unattended setting who have a cloaca, where the rectum and vagina are essentially one opening! This can be repaired surgically even years later. Despite what some may say, even the best doctors and midwives will encounter 3rd- and 4th-degree tears, as childbirth is a traumatic event to the tissues of the vagina and perineum. Repair of an episiotomy is generally straightforward. Do a good exam, identify the tissue edges, then sew with suture that lasts at least a few weeks. (Chromic catgut is a common episiotomy suture that lasts about 2-3 weeks). Errors can be made by doing a hasty repair, or, more commonly, not having good enough visualization of the area to be repaired. Poor lighting, excessive bleeding, a moving target, or, in some, cases, an uncooperative patient (i.e. someone high on crack cocaine who doesn't want to sit still) can all make it hard to repair the area. If the area is not approximated correctly, or even if a stitch pulls through later, the edges of the wound may not heal correctly. Some women heal "too well" and form granulation tissue, which can create spotting and pain. In other cases a trigger point is formed, usually right at the 6 o'clock position at the bottom of the vagina, which can cause extreme pain with insertion of a tampon, finger, or penis. Sadly, many women do not report this to their doctors. Maybe they are concerned about hurting their doctor's feelings, or maybe they are embarrassed, or busy with their newborn. Regardless, episiotomy pain can almost always be fixed. If it's a fistula, surgical repair will solve the problem. If it's a slightly tender episiotomy, ice packs, numbing cream, sitz baths, and wearing loose clothing may help. Breastfeeding moms may benefit from a low-dose estrogen cream, as breastfeeding decreases the amount of estrogen in the vaginal tissues. In cases where there is a bunching up of tissue, or there are knots or other abnormalities, outpatient surgical revision of the area may help. Most patients feel it's better to go through more surgery and have a 6-8 week recovery than have a lifetime of painful intercourse. In cases where trigger points are identified, injections may be helpful. In some cases a combination approach may help, such as removing the excess tissue, the doing injections later if necessary. Again, however, this is often not that hard to fix for an experienced gynecologist. If someone has not obtained relief from the basic treatments, then more intensive treatment is often indicated. Gynecologists are used to dealing with patients with painful intercourse, so you should get attention to this problem from your doctor. If not, find another. Pelvic pain in women is a growing area of concern for health care providers as well as women with disorders that involve the pelvic area (bladder, pelvic floor muscle, rectum and uterus.) Chronic pelvic pain and vulvodynia, two frustrating pelvic disorders seen in young adult women, are not well understood. Research on these two conditions, which are often linked under the umbrella of "chronic pain syndromes", is scarce, especially as it relates to successful treatments. Ask an Incontinence Nurse Underwear Buying Guide Women with chronic pelvic pain or vulvodynia tend to visit specialists who provide non-surgical treatments for incontinence and other pelvic disorders because they seem appropriate. This article will provide an overview of the clinical picture of both conditions, describe specific evaluation techniques, and outline practical treatment options that can be provided. Chronic Pelvic Pain Chronic pelvic pain (CPP) is most often seen in adult white women and is defined as any pelvic pain that continues for more than six months. CPP can be identified clinically by six common characteristics. * Duration of six months or longer * Incomplete relief with most treatment * Significantly impaired function at home or work * Signs of depression (e.g. early morning awakenings, weight loss, anorexia) * Pain out of proportion to pathology * Altered family and social roles The pain of CPP originates in the lower abdomen and pelvis, although it may extend downwards to involve the lower extremities or upwards to the thoracolumbar (chest) area. Pelvic pain can be intermittent (cyclic) or continual in duration and change in relation to physical and mental fatigue, depression and anxiety; dyspareunia (painful sex /intercourse) causing decreased sexual activity, and interruptions in sleep. Activities such as changing position, sitting or standing for long periods, and exercise can trigger pain. Rectal itching and burning on when having a bowel movement associated with irritable bowel syndrome (IBS) are other typical symptoms. Other medical conditions that may present as chronic pelvic pain syndrome include interstitial cystitis, overactive bladder (OAB), and urethral syndrome. Irritable bowel syndrome and other colorectal problems may also give rise to symptoms that mimic chronic pelvic pain, and may even coexist to produce a confusing overall picture. CPP often encompasses psychological and environmental factors along with a collection of physical factors. Because a single concise cause is rarely identified, treatment of just one aspect of the syndrome will not necessarily produce a cure. Studies have shown that women with chronic pelvic pain are more likely to have a history of sexual abuse compared to other groups of women. These women are often referred to many different specialists and, in the process, they may be subjected to expensive tests and exploratory surgery only to be told that 'nothing is wrong' because no underlying pathology was discovered or identified. Many women consent to hysterectomy or other major surgery and still experience pelvic pain. CPP is often intractable and unremitting and may lead to lifestyle changes that affect work, recreation and personal relationships. An integrated multidisciplinary team approach to treatment is often the best way to give the woman the greatest chance of a long-term cure. Symptoms of Chronic Pelvic Pain in Women: * Anxiety and depression. * Involuntary contractions (spasms)of the levator ani and perineal muscles can lead to pelvic pain and is called vaginismus. This condition is often called pelvic floor tension myalgia and is accompanied by painful and difficult penetration of the vagina. * Fatigue, both mental and physical. * Rectal itching. * Burning during the frequent bowel movements associated with Irritable Bowel Syndrome. * Sleep interruptions. * Low back pain and a feeling of heaviness in the lower abdomen. * Leg pain that radiates from the groin. * Constipation or diarrhea. * Irregular or painful menstrual cycles. Vulvodynia The International Society for the Study of Vulvar Disease (ISSVD) defines vulvodynia as chronic vulvar discomfort or pain, especially characterized by complaints of perineal burning, stinging, irritation, or rawness. The most common symptoms are dyspareunia (pain during intercourse), severe point tenderness upon touch, perineal irritation and vestibular erythema (redness and inflammation). Women with vulvodynia also complain of perineal hypersensitivity to clothing or touch and often report urological symptoms such as urgency, frequency, and dysuria, all of which are similar to those seen with interstitial cystitis. Vulvodynia that has persisted for more than six months has more in common with chronic pelvic pain than with other gynecologic disorders. Unexplained vulvar pain is often accompanied by physical disabilities, limitation of simple daily activities (such as sitting and walking), sexual dysfunction and psychologic disability. When vulvodynia is accompanied by pain during intercourse, many factors may be at work including psychologic causes. Vulvodynia and self-esteem issues are often interrelated. Since vulvodynia is a relatively new diagnosis, its incidence and prevalence have not been well studied. Before the 1980s, very little about the condition had been published in the medical literature. Vulvodynia is distributed across a wide age group, from the twenties to the sixties, and it is limited almost exclusively to white women. The obstetric and gynecologic history of women with the condition is usually unremarkable. The onset of vulvar pain is usually acute (sudden) and may be associated with episodes of vaginitis or certain therapeutic procedures of the vulva (cryotherapy or laser therapy). In general, causes of the condition are unknown. Even in those women who complain of vaginitis or itching, bacterial and fungal infections are uncommon causes of vulvar discomfort though vulvar pain is sometimes triggered by bacterial and viral infections. Vulvodynia often becomes a chronic problem lasting months to years. Furthermore, many patients with vulvodynia suffer from other chronic neurological problems such as burning and pain of the tongue and chronic facial pain. Most women with vulvodynia consult several physicians before being diagnosed and may be treated with multiple topical or systemic medications while experiencing minimal relief. Sometimes an inappropriate therapy may actually make the symptoms worse. Since physical findings, including the results of cultures and biopsies, are frequently inconclusive, women may be told that the problem is primarily psychologic. Types of Vulvodynia Vulvodynia has been classified into three basic types: 1. Cyclical vulvitis (cyclical vulvodynia), where symptoms come and go, often responds to anti-Candida therapy given over a long period. This group of problems includes herpes simplex infections, severe yeast infections, thinning and cracking of vaginal skin due to decreased estrogen after menopause, lichen sclerosis, and lichen planus. If symptoms persist in spite of appropriate therapy for the specific problem, the patient is often "graduated" to the next category. 2. Dysesthetic vulvodynia is characterized by constant pelvic pain, usually burning pain when touched lightly or spasmodic stabbing pains with extreme skin sensitivity. Most often seen in post-menopausal women, this type of pain is usually not increased by sexual intercourse or examination and can be more generalized to the groin and inner thighs. The pain seems to be associated directly with the nerves in the area. 3. Vulvar vestibulitis is defined as burning, stinging, irritation of the vaginal area on a chronic basis. These patients are usually young and have had many visits and examinations with doctors that don't result in a real treatment plan. Most often association with interstitial cystitis, this type produces pain on intercourse and when the skin is touched. Patients describe the pain as having had their vaginal opening rubbed with sandpaper. Typical Symptoms of Vulvodynia * Pain during intercourse. * Irritation of the perineum that feels like burning, stinging or rawness. * Extreme tenderness of trigger points when touched. * Redness and inflammation of the skin around the vaginal opening. * Increased sensitivity of the skin to clothing and touch. * Urinary urgency, frequency and painful urination. Conclusion to Pelvic Pain and Vulvodynia Commonly seen in clinical practice, chronic pelvic pain and vulvodynia are pelvic disorders that are frustrating to both clinicians and woman. Clinicians should understand the type and number of symptoms in order to comprehensively assess and evaluate women with these conditions. Many non-invasive treatments can be implemented in clinical practice; however, more research is needed to understand causes and appropriate treatments.