Endometriomas may be painful, particularly during sexual activity and before and during menstrual periods.
Doctors can usually diagnose endometriomas during a pelvic examination.
Endometriomas in the vulva are surgically removed.
For unknown reasons, patches of tissue from the lining of the uterus (endometrial tissue) sometimes appear outside the uterus. This disorder is called endometriosis Endometriosis In endometriosis, patches of endometrial tissue—normally occurring only in the lining of the uterus (endometrium)—appear outside the uterus. Why endometrial tissue appears outside the uterus... read more 
. Endometriosis rarely occurs in the vulva (which consists of the labia and other tissues around the opening of the vagina. It is more common in other locations, such as the ovaries.
Sometimes the endometrial tissue forms a cyst (endometrioma).
Endometriomas often develop at the site of a previous operation, such as an episiotomy (an incision to widen the opening of the vagina to help with delivery of a baby) or repair of a tear in the vagina or vulva that occurred during delivery.
External Female Genital Organs
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Symptoms of Vulvar Endometriomas
Endometriomas may be painful, particularly during sexual activity. Endometriomas respond to hormones just as normal endometrial tissue does. Thus, they can enlarge and cause pain, particularly before and during menstrual periods. Endometriomas are tender and may look blue. They can rupture, causing severe pain.
Diagnosis of Vulvar Endometriomas
A pelvic examination
During a pelvic examination Pelvic Examination For gynecologic care, a woman should choose a health care practitioner with whom she can comfortably discuss sensitive topics, such as sex, birth control, pregnancy, and problems related to... read more , doctors can usually see or feel endometriomas that cause symptoms.
Treatment of Vulvar Endometriomas
Surgery
Endometriomas in the vulva are surgically removed. This procedure is usually done in an operating room but may be done in a doctor’s office. A local anesthetic is used.
Doctors do a biopsy of the removed tissue to make sure it is not a melanoma Melanoma Melanoma is a skin cancer that begins in the pigment-producing cells of the skin (melanocytes). Melanomas can begin on normal skin or in existing moles. They may be irregular, flat or raised... read more 
(a skin cancer), which can occur on the vulva and vagina.
