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.
- Bartholin's cysts can cause pain or discomfort, but are not life-threatening.
- Not all cases of Bartholin's cysts require treatment.
- Bartholin's cysts are commonly small and have no presentable symptoms, meaning diagnosis can be delayed until medical examination.
Symptoms of a Bartholin's cyst
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.
Causes of Bartholin gland cysts
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 - 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 (it can be semisolid or include gas).
A bacterial infection may cause the blockage and subsequent cyst. Examples include:
- 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, also known as HIB, which can cause ear infections, and respiratory infections
Diagnosis of a Bartholin's cyst
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 form the genital area. If the woman has started her menopause, the doctor may recommend a biopsy of the cyst to rule out vulvar cancer.
Treatments for a Bartholin's cyst
If the cyst is small and presents no symptoms, the doctor may recommend no treatment - 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.
Bartholin's cyst home treatments
A warm bath can help burst a Bartholin's cyst.
If a small cyst causes discomfort, home treatment options include:
- over-the-counter (OTC) painkillers
- warm baths - may help the cyst to burst
- warm compresses against the affected area can help relieve symptoms
- antibiotics - if an abscess develops, the patient will be prescribed an antibiotic
Bartholin's cyst medical treatments
A doctor may perform a minor procedure where:
- a catheter is inserted into the cyst
- the catheter is inflated to fix it in place
- for 2-4 weeks, fluid is drained by the catheter, and a normal opening is formed
Other treatments include:Marsupialization - this involves cutting the cyst open and draining 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 the woman has many recurring cysts and does not respond well to any therapies, the doctor may recommend removing the Bartholin's gland.
Bartholin's cyst prevention
Contraceptive barriers such as condoms can help prevent Bartholin's cysts.
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.