Sexually Transmitted Diseases/Small black tissue, inside vagina



After I was done having sex with my girlfriend, I looked at her vagina. As I spread her lips, I noticed something wasn't right. There was a tiny black presence on the inside of her vagina, to the right (my right, as I face her). Surrounding it was what appeared tissue tearing, and when I touched it, she squirmed in pain. Even spreading the lips caused her pain.

I can't tell how long it was since I looked at her vagina in this detail, but it was certainly not present at the time.

I have attached a photo of it. She is going to see a doctor/gyno this coming week, but do you believe it to be cancer, or an std? She has not had any other sexual partners, and I haven't since I have been with her. I do not have any STDs either, but at one point I was believed to have genital warts, but two other doctors told me that they weren't warts, but rather a mole or cyst.

I am very worried for her sake. She is 19 years of age, and I am 22.

Thank you

Hello Matthew,
It is good that both of you are concerned, and that she is going to the gynecologist later in the week for an examination. The reason for the discomfort was irritation from spreading the labia. There may have been a slight bruise or tear from recent sexual activity which is trying to heal. Any mild injury may be painful when stressed from applying tension to the affected area. The actual black area is not really black, but is probably an underlying and superficial blood vessel that appears dark because overlying epithelial tissue (skin) has pulled away making it easier to see. It's dark in color bacause it is probably an underlying vein (or venule) or capillary bed.  

It is NOT cancerous (which would appear very white and granular, and is extremely rare in a woman of your age.  Vaginal, vulvar, and cervical cancers are uncommon, but begin to appear in people over the age of 40.  (Ovarian cancers in women occur in younger people in their early reproductive years-- thirties, and testicular cancers in men occur in even younger ages-- teens and twenties.)

It is NOT suggestive of STDs either.  It is probably just mild "trauma" induced that will resolve in a few weeks without any other treatments.

Good luck!

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Mark P. Behar


Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!


Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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