This is a possible scenario that can be seen when a couple undergoes STD screening […]
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A noticeable lump over the groin is usually a symptom that most people will be concerned of. The left and right groins are the area just above the top of the legs, with creases noted over the area that the legs join the rest of the body. The groins house numerous lymphatic nodes and they are generally not palpable. There are also inguinal canals on both groins to allow internal visceral tissues such as ligament to pass through the abdomen to the genital region.
The two most common causes of lumps in the groin are swollen lymph nodes and hernia. Other causes of groin lumps include underlying dermatological condition, cancer, blood vessels disorder such as aneurysm.
In this article we explore the common causes of palpable lumps over the groin, highlight the differentials of possible STD infections and common non-STD causes of groin lump and the importance of reaching out to your health care providers for evaluation.
Both our groins are full of lymphatic nodes and drainage. These are network vessels and circulations that collects lymph fluid (made up of white cells) to clear and fight against any external pathogens or infections. Occasionally, when the body or immune system is filtering and fighting against external pathogens, the lymph nodes nearby to the source of infection will be swollen and tender. The presentation of lumpy painful lymph nodes over the groin can be the first sign of the body trying to inform us that the body is having a brewing infection including STDs. STDs that can cause both local genital symptoms or general symptoms, such as:
STDs that can be associated with lymph node swelling include:
The important caveat here, although STDs can present with abnormal additional genito-urinary symptoms, having no symptoms does not rule out STDs. The only way to confirm or rule out presence or absence of STDs is via testings.
One can still have STDs, and remain indolent and asymptomatic or present with just a lymph node lump felt over the groin.
Do consider reaching out to your health care providers if you have palpable lymph nodes over the groin and have potential exposure to STDs. Once the underlying infection or STDs are managed, the groin lymph node will eventually subside.
 Skin STDs are usually due to direct skin-to-skin contact from the affected external party (partners) leading to direct inoculation and acquisition of the pathogens. This can lead to clinical presentation of unusual ‘lumps’ or ‘bumps’ over the genital or groin area.
| Skin STDs | Presentations |
| Human Papillomavirus (HPV) | Warts |
| Pox Virus | Molluscum Contagiosum lesions |
| Herpes Simplex Virus | Painful punch-out blisters and erosions |
| Syphilis | Painless ulcer (Chancre) |
| Scabies/ Lice | Itchy red eczema-like patch/areas, Possible moving mites |
| Monkey Pox | Unusual, never seen-before: Painful, deep-seated ulcers with a ‘dot’ on the top of the lesions |
As STDs has potential to spread to other sexual partner(s) and can be associated with long term comorbidities such as infertility, one should seek medical assistance for further evaluation and early treatment of STD groin lumps.
Not all lumps in groin are sexually related and sexually transmissible. Lumps in groin can be due to common skin conditions such as a cyst or a boil or an inflamed hair follicle in the case of folliculitis. Medical treatment may be required if the lump(s) causes inconveniences, pain, irritation, is infected or purely treated for aesthetic reasons.
Lumps in the groin can also be a hernia. Hernia is the medical condition that occurs when the internal organs or body viscera are protruded through a weaken abdomen or groin. When hernia occurs, it can present as a lump seen over the groin. Hernias are usually painless and can be reduced/ tucked back into the body by lying down, changing body position. Nonetheless, it can get trapped and remained externally as a ‘lump’, causing pain, strangulation of the internal organs or even necrosis of the organs and may require surgery in severe cases.
Blood vessel structural causes such as aneurysm can present as a lump over the groin. When there is weakness on the blood vessel (artery) wall, the wall may bulge-out and present as a lump in the groin. The lump can be noticeable ‘pulsating’ when one place the finger over it. This can cause pain, bleeding or even can be dangerous.
Less commonly, yet imperative not to miss, lumps in groin can be due to underlying cancer, blood malignancies such as leukemia and lymphoma. One may have other constitutional symptoms such as weight loss, feeling poorly, fever and etc. You should always get your ‘lump’ checked with your healthcare providers.
Although some groin lump are benign and self-resolving, you are encouraged to seek medical attention to evaluate unusual lump when you first notice it.
Red-flags of requiring medical attention without further delay include:
Your doctor will obtain a relevant medical history. In the context of concern of possible STDs infection, your doctor may acquire personal sexual history. Your doctor will then perform a physical examination by palpating the lump over the groin.
Investigations will also be carried out, such as:
Treatment of lump on the groin depends on the underlying cause.
It is important to pick up common reversible causes such as infection including STDs as the infections are usually treatable or manageable with the right antibiotics or antiviral medication. Delaying or ignoring the signs and symptoms may lead to future health complications such as scarring and infertility.
Operation may be required if there is concern of cysts, hernia, aneurysm or other structural causes. Chemo or radiotherapy may be required if there is concern of underlying malignancy/ blood disorders.
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