The Lamen

BARTHOLIN’S CYST: CAUSES, SYMPTOMS, AND TREATMENT

by | Dec 15, 2022

Bartholin’s cyst is a relatively painless fluid-filled swelling on one of the Bartholin’s glands. The Bartholin’s glands are two pea-sized glands located on either side of the opening of the vagina. They secrete a vagina lubricating fluid, protecting the vaginal tissue during sexual intercourse.

About 2 percent of women develop a Bartholin’s cyst in their lifetime, usually developing after puberty. Bartholin’s cysts are not a sexually transmitted disease (STD), and cannot spread from person to person.

What is the Bartholin’s gland?

The Bartholin’s glands, also called the greater vestibular glands, are responsible for the production of mucus that lubricates the vagina and the vulva.

These two pea-sized glands are located at the posterior region of the vaginal opening and are about 0.2 inches in size.

What causes a Bartholin’s cyst?

The Bartholin’s glands are connected to small ducts, which allow the vaginal lubricant to flow out. If these openings somehow become obstructed, a cyst is caused due to the backup of fluid.

It is often not known why the ducts get blocked, but it is sometimes linked to sexually transmitted bacterial infections like gonorrhea or chlamydia, or other bacterial infections. The ducts could also get blocked due to an injury or extra skin growth.

It is not clear why Bartholin’s cysts develop, so it is usually not possible to prevent them. However, they are more common during the reproductive years, especially in sexually active women aged between 20 and 30.

What are the symptoms of Bartholin’s cyst?

Most Bartholin’s cysts do not cause any symptoms, generally being 0.4 to 1.5 inches in diameter. They generally affect only the left or the right side.

Smaller ones may not cause any symptoms, and you may not even feel the pain. The common symptoms include:

  • a tender, painful lump near the vaginal opening
  • irritation, redness, or swelling near the opening of the vagina
  • pain during intercourse
  • discomfort while walking or sitting

While small cysts usually result in minimal to no symptoms, larger Bartholin’s cysts can cause serious discomfort. If the cyst gets infected, an abscess can occur, which results in redness and accumulation of pus underneath the tissue.

The symptoms of an infected or larger Bartholin’s cyst include:

  • redness and swelling
  • pus draining from the cyst
  • significant pain
  • fever
  • chills

While home treatment is generally all you need, in serious cases, surgical drainage of the Bartholin’s cyst becomes necessary.

My Bartholin’s cyst popped. What should I do?

If a Bartholin’s cyst pops, the change can be pretty obvious, with the release of the fluid inside the sac. The common symptoms of a popped Bartholin’s cyst include:

  • sudden relief of pressure in the affected area
  • drainage of a clear or cloudy fluid from the cyst
  • slight pain or tenderness in the affected area
  • a present but less pronounced bump

If your Bartholin’s cyst bursts on its own, this is not a cause for concern. You should clean the clear or cloudy fluid that might be draining from the cyst and clean the area to minimize the spread of infection. You should not, however, try to drain a Bartholin’s cyst by yourself. 

In case the cyst becomes infected, or its popping causes any pain, you should contact your doctor for further instructions.

Diagnosis

A doctor will typically diagnose a Bartholin’s cyst after undergoing the following steps:

  • evaluating your medical history
  • a pelvic exam
  • taking samples of vaginal secretion to test for STDs

For a medical evaluation, you can expect the following questions from the doctor:

  • how long have you had the symptoms?
  • how severe are your symptoms?
  • do you experience pain or discomfort during sex?
  • do you experience pain during normal activities like sitting or walking?
  • does anything aggravate or worsen your symptoms?

If you are postmenopausal or over 40, the doctor may take a biopsy to check for cancerous cells. In case cancer is a concern, you might be referred to a gynecologist who specialized in cancers of the female reproductive system.

Treatment for Bartholin’s cyst

If the Bartholin’s cyst does not cause any pain or discomfort, it is often best to leave it alone. Small cysts can be observed over time to check if they are developing.

In case the cyst does cause symptoms, drainage might be required. There are a number of methods to treat a Bartholin’s cyst.

Home care

Sitting in a shallow warm bath (sitz bath) multiple times a day for three to four days can cause the fluid to drain from the cyst.

Applying a warm compress on the cyst might also encourage it to rupture and drain. In most cases, home care is safe to treat the cyst.

Surgical treatment

There are a few surgical methods to treat a Bartholin’s cyst:

  • Your doctor may make a small incision on the cyst and allow it to drain in case it causes any symptoms. The doctor can give you a local anesthetic so you don’t feel any pain.
  • For large, symptomatic cysts, the doctor can make a small incision and then place a small rubber tube (catheter) in the incision. The tube stays in place for a few weeks to allow for complete drainage.
  • In the case of recurring cysts, the doctor can perform marsupialization. Your doctor will create small, permanent slits, often less than one-fourth of an inch. This prevents the cyst from recurring.
  • In case the cyst is infected or you have a sexually transmitted infection, the doctor might prescribe an antibiotic.

In case the following treatments are effective in getting rid of persistent cysts, the doctor may recommend surgical remover of the Bartholin’s gland. This is suggested in extremely rare cases, as it carries a risk of bleeding and complications.

While you can’t prevent a Bartholin’s cyst, taking precautions can help prevent developing any complications.

Vaginal hygiene is important to prevent the risk of bacterial infection and developing an abscess. Using a condom during sex also helps prevent the cyst from becoming infected.

In a nutshell

Bartholin’s cysts are a rare condition occurring in about 2 percent of women during their lifetime. These cysts are often so small that they are not even easily noticed, and can go away if left alone.

Recurring cysts and more serious infections can require surgical treatment, which often requires draining the cyst. It is important to maintain vaginal hygiene to make sure the symptoms don’t worsen.

Bartholin’s cysts are more common in women during their reproductive age, between 20 and 30. If you’re over 40 or post-menopausal, you should consult a doctor if you develop a cyst. A biopsy might be required to determine whether there is a risk of cancer.