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Published on: 7/14/2026
A painful lump on the perineum is most often caused by a cyst (such as an epidermal cyst or a deeper cyst between the muscles), a bacterial infection leading to an abscess, or, in rare cases in women, endometriosis. Common symptoms include tenderness, swelling, redness, and discomfort when sitting or walking. Treatment depends on the underlying cause and may include warm compresses, pain relief, antibiotics for infection, or minor surgical drainage or excision when necessary. Because a perineal lump can range from a harmless cyst to a serious infection, any painful lump in this area should be evaluated by a doctor promptly to prevent complications.
Not sure if your symptoms warrant an urgent visit? A free, instant, online symptom check can help you understand what may be causing your lump, identify red flags, and guide your next steps—so you can decide with confidence whether to self-monitor at home or seek immediate care.
Reviewed for medical accuracy: 07/14/2026
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Submit your own QuestionWhen you find a painful lump on the perineum, several things could be causing it. One common cause is a cyst, which is a small sac filled with fluid or skin cells. Sometimes, a cyst can become infected or even rupture, causing pain. For example, an epidermal cyst can become tender if it gets inflamed.
Another possibility, particularly in women, is perianal endometriosis. This is rare but occurs when tissue similar to the lining of the uterus grows in the perineal area, causing discomfort and pain. Treatment depends on the exact cause. For a minor cyst that is not too painful, conservative measures like warm compresses, anti-inflammatory medications, and keeping the area clean may help.
However, if the lump is very painful, shows signs of infection such as redness or pus, or if it does not resolve on its own, a doctor might decide to drain or surgically remove it. To better understand what might be causing your symptoms and get personalized guidance, you can check your symptoms with Ubie's free AI-powered tool. It is important to have any persistent or worsening lump examined to determine the correct treatment and to avoid complications.
(References)
Lake E, Engledow A, Cohen C. An unusual perineal swelling: a cyst between the sphincters. J Surg Case Rep. 2010 Nov 1;2010(9):2. doi: 10.1093/jscr/2010.9.2. PMID: 24946354; PMCID: PMC3649172.
Gupta R, Verma P, Bansal N, Semwal T. A Case of Ruptured Perineal Epidermal Cyst. Cureus. 2020 Oct 22;12(10):e11099. doi: 10.7759/cureus.11099. PMID: 33240695; PMCID: PMC7681750.
McComb K, Barghash M, Eltayef S. Perianal Endometriosis: An Uncommon Site for a Common Problem. Cureus. 2023 Sep 7;15(9):e44840. doi: 10.7759/cureus.44840. PMID: 37809144; PMCID: PMC10559834.
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