Can itchy lumps on my anus be PROLAPSE?

Resolved question:
Hello Dear Doctor
My name is Sharona and I am a 43 year old female. Around 9 months ago, I started to suffer from anal itching. It is rather intense at night, after using stool and during / after having anal intercourse or anal masturbation. I also have few lumps on my anus ring that seem to grow outside of my anus hole as an extended piece of flesh. They are very sensitive but they are odd and it really troubles me.
I am normally healthy. I am 178cm and 75kg. I would like to note that I was born as 'male' but been living as female since my early 20th. I am not taking any hormones for the past 5 years. I am pre OPS as you can imagine.
I used to be more sexually active up until 5 years ago, but now have only one partner and I am not sure if keep having anal intercourse is advisable (I still use toys and fingers since that condition started but I fear I may do myself more harm)
One doctor I spoke with said I may have a condition called prolapse, due to loosening of the anal sphincter usually as a result of anal intercourse or such activities.
I really would like a second opinion.
I also want to know if I can keep having anal intercourse and if so what secure measures I should be taking and also whether I can just 'live' with this situation or what would be the best treatment


Thank You

Submitted: 4 Days
Category: General Surgeon

Expert:  Dr. Hari Charan Perigela replied 4 Days.

Hello.



Thank you for your query at DoctorSpring.com.



I understand your concern.



As per your description and pictures, you seem to have anal warts, flesh like lesions at the Anal opening. These are caused by Human paillpma virus and can be transmitted sexually. They can be left alone if they are not causing excessive discomfort. If excessive discomfort is present, you can get them removed surgically. 



In prolapse, some part or whole of the inner layer of the rectum and anal canal will come out which doesn't seem to be your case from the pictures. However, it has to be confirmed by a surgeon after clinical examination. 



It is not advisable to have anal intercourse as it will only worsen the condition. 



I request you to meet a general surgeon, confirm the diagnosis and proceed accordingly. 



Feel free to ask queries.



Wish you good health.



Regards. 


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Patient replied :

Dear Dr. Hari Thank you for getting back to me and giving me your observation. I have few questions if I may: I was wondering if there is any specific diet I need to take and if there are any lotions / creams I can apply so that discomfort will be minimal. I usually put some vaseline around the anus hole and inside before I go to sleep and sometimes during the day. Also, is it best to wash the anus area with soap and hot water or should I use mild temp. water and no soap? What about use of toilet papers - is it advisable or should I use wipes? I typically use papers but when the itch is intense I use wipes As for sexual intercourse - I can see your point, but did you mean with a partner or all together. Meaning can I still be stimulating myself using my hand and toys that are softer Thank you again Kindly Yours Shaona


Expert:  Dr. Hari Charan Perigela replied 3 Days.

Thanks for choosing doctorspring.com



Regarding diet,you should eat high fiber diet,so that your stools will be soft.If the stools are hard,there is chance of injury to the anal canal.



I prescribe Cream containing Sucralfate and Xylocaine combination for anal pain.If it is available in your area,you can use it.Instead of Vaseline,you can use Xylocaine jelly if the above combination cream is not available.



Hot water should be avoided.You should use warm water and there is no need to use soap.



Regarding usage of toilet paper or wipes,there is no much difference.You can use them as per your comfort levels.



I request you not to use the anus for any other purpose other than passage of stools.Any object can cause injury to the inner layer of the anus causing complications.



Wish you good health



Regards


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Patient replied :

Dr. Hari
Thank you again. Your feedback is appreciated. If i may, I have one more issue to bring up which I am not sure if it is somehwat related to my condition
As I said in my first visit, when I was 27 I started a hormone treatment (mainly based on astro). During this time and until I became 35 hormones affected me and I rarely had any penis erection when having intercourse. When I was 35 I stopped my hormone treatment. I was hoping that over the years I will be able to get normal penis erections since I stopped hormones, but sadly I am not able to. when I am aroused I can get maybe a 50% erection, and when I have an orgasm there is almost no seed coming out
Can HRT have had the virus papiloma impact on my body? From your experience, is my erection ability will ever be revesable or the HRT effects will now be with me forever
Sharona Lisa


Expert:  Dr. Hari Charan Perigela replied 2 Days.

Hello.



Hormones do not affect the pailloma virus.



In order for me to provide a better and informed opinion about your other query, I would like to know the names of hormones you have taken and the duration of treatment. 



Waiting for your reply, 

Regards.


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Patient replied :

The hormones I took were: estradiol cypionate, estradiol enanthate, progesterone, and Cyproterone acetate
I started taking it when I was 27 till I was 35


Expert:  Dr. Hari Charan Perigela replied 1 Day.

Hello.

These hormones will decrease libido and may lead to impotence. So, erection may not be possible in many taking those drugs. However, this change is reversible. As you have stopped HRT, the effect of these hormones can be reversed. As you are already getting 50% erection, with positive thinking, you may regain normal erection gradually.

As I mentioned earlier, HRT has no relation to Human papilloma virus.

Hope I have addressed your concern.

Regards.


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