A Bartholin’s cyst, or Bartholin’s duct cyst, occurs when the duct of the Bartholin’s gland is blocked, resulting in the development of a fluid-filled cyst.
It may sometimes be caused by an infection, but a Bartholin’s cyst is not an infection.
The Bartholin glands are situated between the vagina and the vulva (the external part of the female genitals) and produce a fluid that helps reduce friction during sex. They are not normally visible to the naked eye.
Thomas Bartholin (1616-1680), a Danish physician, mathematician, and theologian, was the first person to describe these glands, hence their name. He was best known for his work in the discovery of the lymphatic system in humans.
The Bartholin’s glands, also known as the major vestibular glands, are a pair of glands between the vagina and the vulva that produce lubrication when stimulated.
Along with the lesser vestibular glands, they aid in sexual intercourse by reducing friction.
The lubricating fluid goes from the Bartholin’s glands down tiny tubes (ducts) which are about 0.8 inches (2cm) long into the lower part of the entrance to the vagina.
If there is a blockage in these ducts, the lubricant builds up. The ducts expand and a cyst is formed. This is a Bartholin’s cyst. When the cyst is formed, there is a risk of infection in the area, and a subsequent abscess.
A woman is more likely to have a Bartholin gland cyst when she is:
- young and sexually active
- has not yet become pregnant
- has just had one pregnancy
A cyst is a closed sac-like structure full of liquid, which can be semisolid or include gas.
A bacterial infection may cause the blockage and subsequent cyst.
- gonococcus, which causes gonorrhea
- Chlamydia trachomatis, which causes chlamydia
- Escherichia coli, which can affect water supply and cause hemorrhagic colitis
- Streptococcus pneumonia, which can cause pneumonia and middle ear infections
- Haemophilus influenzae (HIB), which can cause ear infections, and respiratory infections
If the cyst is small and presents no symptoms, the doctor may recommend no treatment, but the patient will be asked to report any growth in the size of the cyst.
Any lump in the vaginal area should be reported, especially if the patient has started the menopause.
If treatment is offered, the doctor may prescribe antibiotics.
Sometimes minor surgery is recommended.
This will involve:
- inserting a catheter into the cyst
- inflating the catheter to fix it in place
- leaving the catheter for 2 to 4 weeks, to allow the fluid to drain by the catheter, and a normal opening to form
Other treatments include:
Marsupialization: The surgeon cuts the cyst open and drains the fluid out. The edges of the skin are stitched open for the secretions to come through.
Carbon dioxide laser: This can create an opening to help drain the cyst.
Needle aspiration: A needle is used to drain the cyst. Sometimes, after draining the cyst, the cavity is filled with a 70 percent alcohol liquid solution for a few minutes before being drained out, to reduce the chances of infection.
Gland excision: If there are many recurring cysts that do not respond well to any therapies, the doctor may recommend removing the Bartholin’s gland.
If a small cyst causes discomfort, home treatment options include:
- painkillers such as ibuprofen, available to purchase over-the-counter or online
- a warm bath may help the cyst to burst
- a warm compress against the affected area can help relieve symptoms
It is not uncommon for a woman to have a Bartholin’s cyst and not know about it until she is examined by a doctor. Commonly, there are no major symptoms, however, they may include:
- Lump – a slight lump in the labia (the lips of the female genitalia) is a minor symptom that may not be noticeable. The cyst usually only develops in one of the two glands.
- Pain – larger cysts can cause discomfort and pain in the vulva, especially during sexual intercourse, or while walking or sitting.
- Abscess – if an infection develops there may be a collection of pus, which can be painful.
The abscess can develop very quickly. The skin in the affected area may become red, tender, and hot. The patient may also have a fever.
Any cyst-like symptoms or lumps in the genital area should be reported to a doctor and checked for cancer.
A doctor can usually diagnose this type of cyst during a pelvic examination.
The doctor may advise the patient to test for possible STDs (sexually transmitted diseases). This would involve urine or blood tests, as well as a swab from the genital area.
If menopause has started, the doctor may recommend a biopsy of the cyst to rule out vulvar cancer.
Sometimes a cyst can become infected. This can lead to an abscess.
In a significant number of cases there is not much the woman can do to prevent the occurrence of a Bartholin’s cyst.
Sexually active people should use a barrier method of contraception, such as a condom.
Some people say that sitting in a warm bath may help the cyst to burst, thus preventing the formation of an abscess.