### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
yes i am 23 weeks pregnant and just today I noticed that i have this small piece of extra skin that was never there before at the very end of my vagina on the left side, near the anus, but still on the vagina. I dont know what it is, I know it cant be an STD, but i still dont know what it is.

### output:

Hello, and I hope I can help you today. There are two main possibilities of what you may be noticing on your perineum, both of which are common during pregnancy. The first possibility is that the extra skin is actually a skin tag, which is a bump that grows from a combination of the hormones of pregnancy and the skin in the area rubbing against itself or your underwear.  The following is a link for some images for vulgar skin tags: http://s3.yyyyyyyy.com/f01.juyyyyyyy.com/JACUSTOMERn0orgmgx/2014-03-01_201304_20140301_134800.jpgThe second, and more likely diagnosis, is an external hemorrhoid.  Hemorrhoids are bulging veins near the anus that cause the skin overlying them to grow more-causing the appearance of extra skin.  Here is a link to a picture of a typical external hemorrhoid: https://www.ay.com/mya/gallery/photo/cyyyy/1/image/640x480/9df78eayyyyyyyyyyyyyyyyyyyy/8/5/85.jpg Hemorrhoids can sometimes itch or bleed if they get larger; if you experience these symptoms you should contact your prenatal care provider. The good news is that both of these conditions usually resolve after the baby is born and require no treatment.  You may find that other moles on your skin may get larger during pregnancy as well, and they typically decrease in size after the birth. So I hope I was able to answer your question and that these images help clarify your condition. Best wishes for the rest of the pregnancy,