Rarely, endometriosis occurs in the vulva (or the vagina), sometimes producing cysts (endometriomas), often at the site of previous surgery or a wound (eg, episiotomy, laceration during childbirth).
Endometriomas usually develop in the midline. They may be painful, particularly during intercourse. During menstruation, pain increases and endometriomas may enlarge. Endometriomas are tender and may appear blue. They can rupture, causing severe pain.
Diagnosis of vulvar endometriomas is by physical examination and biopsy.
Treatment of vulvar endometriomas involves excision.