What Is a Bartholin's Cyst?
A Bartholin’s cyst, also called a Bartholin’s gland cyst, is a small fluid-filled lump (cyst) that can form on one or both sides of the vaginal opening, where the Bartholin’s glands are. The glands are small, about the size of a pea, but you usually can’t notice them. Their role is to produce lubricating vaginal fluid.
The fluid travels to the vagina through ducts (tubes). Occasionally, one or both Bartholin glands become blocked and cause the fluid to build up, forming a cyst. These cysts are common among people of childbearing age, affecting about 2 of every 10 women.
Bartholin's cysts mostly occur on one side, but some people get them on both sides. They're almost always benign, or not cancer.
The cysts aren’t always obvious and are sometimes only found during a medical exam.
Bartholin Abscess
Occasionally, a Bartholin’s cyst can become infected. If this happens, the gland fills with pus. This is called a Bartholin’s gland abscess. Unlike a cyst, an abscess is firm and painful and can interfere with your everyday life.
Bartholin’s Cyst Symptoms
You may not know you have a Bartholin’s cyst because there aren’t always symptoms.
If the cyst gets infected, it can become tender, swollen, and red. It can be filled with fluid and range in size from a pea to a golf ball. You may have irritation, discomfort, or pain when walking, sitting, wiping after using the toilet, or having sexual intercourse. It also could be painful to insert or remove tampons.
Other symptoms of an infected Bartholin's cyst include:
- Swelling in the area
- Redness
- Drainage
- Growth in size
- Fever and chills (if you have an abscess)
If the cyst is large, it can make one side of your labia majora (the large folds of skin on the outside of your vagina) hang lower than the other.
Causes of Bartholin’s Cyst
It isn’t always clear why the Bartholin’s glands get blocked.
A blockage could result from long-term irritation, but it can also be caused by:
- Injury to the area or after childbirth, with or without an episiotomy
- Sexually transmitted infections (STIs) like gonorrhea or chlamydia (in rare cases)
- Bacterial infections like E. coli.
Most Bartholin's cysts do not become infected and aren't contagious upon skin-to-skin contact. Cysts that are caused by STIs, however, can be spread.
The cysts typically happen in your childbearing years but, in rare cases, can occur after menopause. They’re less likely to develop as you age. People who are postmenopausal should have vaginal lumps checked.
Bartholin's Cyst Risk Factors
Any person with a vagina can develop a Bartholin’s cyst or abscess, but some may be more likely to develop one (or more). This includes those who:
- Are in their 20s or 30s
- Have been exposed to an STI
- Have had a trauma or injury to the area
- Have had a previous Bartholin's cyst
Bartholin’s Cyst Diagnosis
Only your doctor can tell you if you have a Bartholin’s cyst. They’ll do a pelvic exam to check the vaginal opening and to feel for a bump. If you have drainage, they’ll take a sample so it can be looked at under a microscope for signs of an STI or other bacterial infection. If you have an abscess, they’ll take a sample from it and send that to a lab.
If you’re over 40, they may do a biopsy (take a sample of tissue from the cyst) to rule out vulvar cancer. Vulvar cancer from a Bartholin’s cyst is rare, affecting only about 5% of women (5 out of every 100) who have vulvar cancer.
It's more common for the Bartholin's gland to develop into cancer if you are over age 60. If your doctor determines your cyst may be cancerous, they may recommend having it removed by surgery.
Bartholin's Cyst Home Treatment
You probably won’t need medical treatment if you’re under 40, your cyst isn’t causing problems, and you aren’t showing any signs of an infection. Most Bartholin’s cysts go away on their own, usually within a few weeks. But if you’re uncomfortable, there are a few things you can try at home.
Warm compresses. Apply a clean cotton cloth soaked with warm water to the area until the cloth cools.
A sitz bath:
- Fill a tub with 3 to 4 inches of clean, warm water (enough to cover your vulva), and gently sit.
- Repeat this several times a day for 3 or 4 days.
- The cyst may burst and drain on its own.
Over-the-counter pain relievers. If you are experiencing pain, taking an over-the-counter painkiller as directed may help ease the discomfort.
While treating your cyst at home, it may drain or burst. This is OK, but do not try to pop the cyst on your own as this could lead to infection. If the cyst is that bothersome, you should see your doctor.
Will a Bartholin's cyst go away on its own?
Bartholin's cysts usually do go away on their own. To lessen infection risks, it's important to keep the area clean and dry and to avoid squeezing or popping the cyst. If the cyst becomes painful or infected or does not go away or improve over several weeks, talk to your doctor.
Bartholin’s Cyst Treatment
If your exam shows that you have an STI, or if your cyst is infected, your doctor will prescribe an antibiotic. They may also prescribe topical medications to put on your skin.
If the Bartholin’s cyst is causing problems -- or if it’s turned into an abscess -- you’ll need to see your doctor. They’ll treat it in one of the following ways:
- Surgical drainage. The doctor will make a tiny cut in the cyst. They’ll place a small rubber tube (called a catheter) into the opening to allow it to drain. It can stay in place for up to 6 weeks. You’ll probably feel better right away after the fluid is gone. But you may need to take pain medication for several days afterward. Keep in mind that a Bartholin's cyst or abscess may come back and need treatment again. Side effects include pain or discomfort, especially during sex. You might also have swelling of the labia (lips around the vagina), infection, bleeding, or scarring.
- Balloon-tipped catheter. Your doctor may choose to use a balloon-tipped catheter. This procedure is done in the doctor’s office. After making a small cut, they insert a small balloon-tipped catheter into the cyst. It remains in place for 4 to 6 weeks and encourages the body to form a permanent opening for any future drainage. You will be able to perform your usual activities, although sexual activity may be uncomfortable and discouraged while the catheter is in place.
- Marsupialization. If cysts bother you or come back, this procedure may help. The doctor cuts the cyst open, then stitches the skin around it to form a small pouch. This lets the fluid drain out. The doctor will pack the area with special gauze to soak up the fluid and any blood. The process takes less than half an hour, and you can go home the same day. Your doctor may prescribe painkillers afterward. There’s also a risk of infection, bleeding, and the abscess coming back.
- Removing the gland. Your doctor might recommend this option if others haven’t worked or you keep getting Bartholin’s cysts and abscesses. This surgery takes about an hour. You’ll get anesthesia to put you to sleep during the procedure, and you may be able to go home afterward. Possible problems include bleeding, bruising, and infection.
- Needle aspiration. Some research suggests simple needle aspiration can be effective in Bartholin's abscesses and can be done as on outpatient procedure without the need for general anesthesia.
- Carbon dioxide laser. This minimally invasive surgical treatment option that uses a laser to remove a Bartholin's cyst. It is quick and can be done as an outpatient procedure, but it can be expensive.
Bartholin’s Cyst Prevention
You can’t prevent a Bartholin’s cyst. But safer sex measures like using condoms may help prevent an infection or cyst caused by an STI. Practicing good hygiene can also help.
