The Bartholin's glands are two small, pea-shaped glands located on each side of the vaginal opening that secrete fluid to lubricate the vagina. If the glands become blocked, the fluid can become trapped, causing a cyst to form. An infected Bartholin's cyst might cause an abscess.
A person will know if they have an abscess because they cause intense pain on one side of the vagina, along with redness and swelling in the general area. Abscesses vary in size from very small to over an inch in diameter.
Almost 1 in every 50 women will experience a Bartholin's cyst or abscess at some time. Those of childbearing age, particularly those in their 20s, are most at risk.
In this article, we discuss the causes and symptoms of a Bartholin's abscess. We also look at which medical treatments and home remedies can cure the abscess and ease symptoms.
What causes a Bartholin's abscess?
Pain during sex and a fever may be symptoms of a Bartholin's abscess.
In a study of 219 women with Bartholin's abscesses, almost 62 percent tested positive for a bacterial infection. E. coli was the most common culprit, being responsible for 43.7 percent of infections. The bacteria was also significantly more common in cases of recurrent infection.
Almost 8 percent of cases involved more than one type of bacteria.
Other bacteria species that play a role in abscess development include:
- Brucella melitensis
- Klebsiella varicola
- Neisseria sicca
- Pasteurella bettii
- Pseudomonas aeruginosa
- Salmonella panama
- Staphylococcus aureus
- Streptococcus species
Abscesses tend to be very painful. People who have a Bartholin's abscess will typically experience pain on one side of the vagina only — the side of the infected gland.
Other signs and symptoms include:
- a lump under the skin on the affected side of the vagina
- pain during walking, sitting, or sex
- redness, swelling, and a hot sensation around the abscess
If the abscess grows big enough, it may break the skin. Medical professionals refer to this as a spontaneous rupture. When the abscess ruptures, the fluid will drain out, and the person may notice discharge from the vagina or that the pain has gone.
How are they diagnosed?
A doctor can diagnose a Bartholin's abscess based on symptoms and a physical examination. During the exam, they will:
- check for lumps in the vagina
- measure temperature to check for fever
- take a cervical swab to test for STIs
Rarely, Bartholin's abscesses may suggest cancer. To rule out cancer, especially in those over 40, a doctor may carry out a biopsy. A biopsy involves taking a small tissue sample to examine under a microscope.
Most cases of Bartholin's abscess require a medical treatment called drainage. If an abscess develops again, a doctor may recommend marsupialization. It may, in rare cases, be necessary to remove the glands.
Bartholin's abscess often requires surgical drainage.
Surgical drainage usually takes place at a doctor's office or the hospital. The doctor may use a local anesthetic to numb the area or a general anesthetic to put the person to sleep.
During the procedure, the doctor makes a small opening (incision) in the abscess. Once the fluid drains out, they will place a catheter — a small rubber tube — in the opening.
The catheter stays in place for up to 6 weeks. It keeps the incision open, which allows all of the fluid inside the abscess to drain out.
The doctor may remove the catheter after this period, or it may fall out by itself.
A procedure called marsupialization can help prevent recurrent Bartholin's abscesses.
First, the doctor will make a small incision in the abscess so that it can drain. They will then use stitches at each side of the incision to create a permanent opening. The opening is typically less than a quarter-inch wide. Sometimes, the doctor may insert a catheter for a few days to speed up the drainage process.
Marsupialization is usually successful. Only 5 to 15 percent of Bartholin's cysts come back after the procedure.
If abscesses still recur after marsupialization, it may be necessary to remove the Bartholin's glands. However, this procedure is considered a last resort and is rarely necessary.
When it is necessary, the procedure takes place in the hospital under general anesthesia. As with all surgeries, there is a risk of bleeding, infection, and other complications.
Antibiotics can clear up any infection that is present in the glands. A doctor will typically prescribe these medications before or after surgical treatment on the Bartholin's glands. Antibiotics are not always necessary, especially if the abscess drains fully and does not recur.
Home remedies can provide relief from the symptoms of a Bartholin's abscess, but they do not usually cure the condition.
The following home treatments may alleviate pain and swelling in the short-term:
Sitz baths can ease pain and discomfort. They may also help very small abscesses to rupture and drain.
To take a sitz bath, fill a bathtub with several inches of warm water. Sit down in the water for 15 minutes.
Repeat this treatment several times daily for at least 3 to 4 days, or until symptoms subside, or a person seeks medical treatment.
According to some people, natural topical treatments can provide relief from Bartholin's abscesses. There is no scientific evidence to support the use of these remedies.
Popular topical treatments include:
- Tea tree oil: Applying a mixture of tea tree oil and castor oil to the abscess may encourage drainage. Tea tree oil has natural antibacterial properties. Use gauze to apply the mixture and place a hot compress on top of the gauze. Hold in place for 15 minutes.
- Apple cider vinegar (ACV): Typically, people who use ACV to treat an infected Bartholin's cyst dilute it and apply it to the cyst with a cotton ball.
Over-the-counter (OTC) painkillers can help make activities, such as sitting and walking, more manageable.
- ibuprofen (Advil, Motrin)
- naproxen (Aleve)
Fever often accompanies a Bartholin's abscess. To treat a mild fever at home:
- drink plenty of fluids
- keep room temperature at a comfortable level
- take ibuprofen
- use cold compresses on the forehead
Call a doctor if body temperature exceeds 102° F or if the fever persists for more than 3 days.
When to see a doctor
Ignoring a Bartholin's abscess may lead to infection.
Anyone who experiences symptoms of a Bartholin's abscess should see a doctor. An untreated abscess could result in the infection spreading to other areas of the body. If the infection spreads to the blood, it can cause a potentially fatal condition called sepsis.
Seek prompt medical treatment for:
- high or persistent fever
- ruptured abscesses
- severe or persistent pain
While home remedies might ease symptoms, they are unlikely to cure an abscess.
It is not always possible to prevent a Bartholin's abscess from developing. To reduce the risk of an infected gland:
- Use condoms to avoid STIs, such as chlamydia and gonorrhea.
- Get regular checkups to test for STIs.
- Practice good genital hygiene and only clean the outside of the vagina.
- Take probiotic supplements to support the urinary tract and vagina.
- Drink plenty of fluids throughout the day.
With medical treatment, a Bartholin's abscess typically resolves quickly. Most people recover within 24 hours of surgical drainage. Most cases of recurrent abscesses go away after marsupialization. These procedures are low-risk and typically do not cause negative long-term effects.
Sitz baths and other home remedies can alleviate symptoms in the short-term while a person is waiting to see their doctor.