Bumps covered by tampons are particularly painful and are most commonly associated with urethral caruncles, which often cause pain in the urethral opening and can cause burning pain. Often, urethral caruncles are generated due to repeated inflammation of the urethra in women after or before menopause. Urethral caruncles are urethral granulomas or vascular polyps, which are benign polypoid organisms at the end of the female urethra, often caused by chronic inflammation of the pubic area due to decreased estrogen levels or localized friction. When a patient develops a urethral caruncle, it can be treated with standardized therapy, such as topical estrogenic medications that will relieve the painful symptoms.