A Bartholin’s cyst is a firm, tender, noncancerous lump. It develops due to a blockage in the Bartholin’s glands, between the vulva and the vagina. If bacteria enter the cyst, an abscess can form, and medical attention may be necessary.
The Bartholin’s glands sit between the vagina and the vulva and are not usually visible to the naked eye. They produce a fluid that helps reduce friction during sex.
Bartholin’s cysts are firm, tender masses that do not always cause pain. Although infectious agents are not responsible for causing the cysts to develop, bacteria can enter the fluid in them once they have formed. If this occurs, the cysts may become abscesses.
In the United States, Bartholin’s cysts are present in about 2% of people seeking gynecological care, according to the British Medical Journal.
In this article, we look at the symptoms, causes, and treatment of Bartholin’s cysts.
Bartholin’s cysts do not always cause pain. A person may have a cyst and not know about it until they undergo a routine examination by a doctor or have a consultation for other gynecological health concerns.
Major symptoms are not common. However, when symptoms do occur, they may include a slight lump in the labia. The cyst usually only develops in one of the two glands.
Cysts may not be noticeable at first, but they can sometimes have effects on the labia, causing one of the lips to become larger than the other.
A cyst is a closed sac-like structure full of liquid, air, or other substances.
Larger cysts are more likely to cause discomfort and pain in the vulva, especially during sexual intercourse, while walking, or when in a sitting position.
Bartholin’s cysts should not be a cause for concern in people of reproductive age.
However, after menopause, it is prudent to check the genitals for any lumps or cysts and seek consultation with a doctor about possible malignancies.
A doctor may prescribe broad spectrum antibiotics to counter the actions of the infectious agent that is creating the pus buildup.
The abscess can develop rapidly. A person may notice the following symptoms in the area around the abscess:
- a sensation of heat from the area
- pain during sexual activity
- rupturing and leakage
The Bartholin’s glands produce a lubricating fluid that helps reduce friction during sexual intercourse.
This fluid travels from the Bartholin’s glands down ducts into the lower part of the entrance to the vagina.
If there is a blockage of mucus in these ducts, the lubricant accumulates. This buildup causes the ducts to expand and a Bartholin’s cyst to form.
The reaction of the immune system to a bacterial infectious agent may cause the blockage and subsequent abscess. Examples of these agents include:
- Neisseria gonorrhoeae, which causes gonorrhea, a disease that is transmissible via sexual contact
- Chlamydia trachomatis, which causes chlamydia
- Escherichia coli, which can affect the water supply and cause hemorrhagic colitis
- Streptococcus pneumoniae, which can cause pneumonia and middle ear infections
- Haemophilus influenzae, which can cause ear infections and respiratory infections
While doctors do not consider Bartholin’s cyst to result exclusively from sexual transmission, N. gonorrhoeae is among the most common pathogens that doctors isolate when testing the cysts.
The exact causes of duct blockage are often unclear, though bacteria have a role to play.
However, the following characteristics increase a person’s likelihood of developing a Bartholin’s cyst:
- being sexually active
- being between 20 and 30 years of age
- having previously had a Bartholin’s cyst
- having experienced physical trauma in the affected area
- having undergone surgery of the vagina or vulva
If a Bartholin’s cyst is small and presents no symptoms, treatment may not be necessary. However, doctors are likely to ask the person to monitor the cyst and report on whether it increases in size or presents discomfort.
If a small cyst causes discomfort, at-home treatment options include:
- Pain relievers: Taking over-the-counter pain relievers, including acetaminophen and ibuprofen, may help a person with a Bartholin’s cyst relieve discomfort.
- A warm bath: Soaking the cyst for 10–15 minutes may help it burst and heal.
- A warm compress: Applying gentle pressure to the cyst with a flannel or cotton wool ball soaked in hot water can help.
It is important, however, to seek consultation about any unusual or suspicious lumps in the vaginal area, especially if a person has entered menopause.
Larger cysts or those that have become abscesses may require drainage and treatment.
If the cyst has developed into an abscess, the doctor may prescribe antibiotics.
For larger cysts, a doctor may recommend surgery after the completion of a course of antibiotics. The procedure for draining a large cyst is known as a balloon catheter insertion.
This procedure takes place under local anesthetic and involves the following steps:
- The doctor inserts a catheter into the cyst.
- They inflate the catheter and may use stitches to keep it in place.
- The catheter remains in place for about 4 weeks to allow the fluid to drain.
Other treatments include:
- Marsupialization: The surgeon cuts the cyst open and drains the fluid. They stitch the edges of the skin open to allow the secretions to come through.
- Carbon dioxide laser: This highly focused laser can create an opening that helps drain the cyst.
- Needle aspiration: The surgeon uses a needle to drain the cyst. Sometimes, after draining the cyst, they fill the cavity with a 70%-alcohol solution for a few minutes before drainage. This solution reduces the risk of bacteria entering the wound.
- Gland excision: If a person has many recurring cysts that do not respond well to any therapies, the doctor may recommend removing the Bartholin’s gland completely.
A doctor can usually diagnose this type of cyst during a pelvic examination.
They may advise an individual to undergo testing for sexually transmitted infections (STIs) on discovering a Bartholin’s cyst. This process will involve urine or blood tests, as well as a swab from the genital area.
If the person has entered menopause, the doctor may recommend a biopsy of the cyst to rule out vulvar cancer.
As doctors are unsure as to the cause of the initial duct blockage, there are not many recommendations for preventing a Bartholin’s cyst.
However, because STIs, such as gonorrhea and chlamydia, can cause the cyst, people who are sexually active can reduce their risk by using barrier contraception, such as a condom or dental dam.
Using the home remedy options in this article can help people with an asymptomatic cyst prevent the formation of an abscess.
A Bartholin’s cyst is a growth on the Bartholin’s glands, which provide lubrication during sexual contact.
The cyst is often painless and barely noticeable until a doctor diagnoses it during a routine examination or while investigating another health condition.
Bacterial infectious agents often cause the initial duct blockage that leads to Bartholin’s cysts, although the exact mechanisms behind the blockage are often unclear. Some STIs, such as gonorrhea and chlamydia, can cause the cyst.
It is often safe to leave small, painless cysts alone or use home remedies to address any discomfort.
However, large cysts or those that have become abscesses may need further medical attention. Several procedures are available for the management of Bartholin’s cysts, including balloon catheter inflation.
It is important to seek consultation about any unusual lumps on the vulva or vagina to rule out cancers and other health concerns.