Bartholins Cyst

The Bartholin’s glands are on each side of your vaginal opening. They’re about the size of a pea. They make fluid that keeps your vagina moist.

The fluid travels to the vagina through ducts (tubes). If they get blocked, fluid can back up into them. This forms a swelling -- a cyst. Doctors call these Bartholin’s gland cysts. Most of the time, they don’t hurt. They’re almost always benign, or noncancerous.

Bartholin’s Cyst Symptoms

You may not have any, unless the cyst is large or gets infected. If infection sets in (doctors call this an abscess), you’ll likely have extreme pain at the site of the cyst. Sex -- and even walking -- may hurt. 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.

Symptoms of an infected Bartholin’s cyst include:

• Fever and chills
• Pain that gets worse and makes it hard to walk, sit, or move around
• Swelling in the area
• Drainage from the cyst

Causes of Bartholin’s Cyst

Doctors aren’t sure why these glands sometimes get blocked. The infection that causes the cyst may result from bacteria such as E. coli. In rare cases, it may be due to bacteria that cause sexually transmitted infections (STIs) like gonorrhea or chlamydia.

About two out of 10 women can expect to get a Bartholin’s gland cyst at some point. It typically happens in your 20s. They’re less likely to develop as you age.

Bartholin’s Cyst Diagnosis

Only your doctor can tell you for sure if you have a Bartholin’s cyst. They’ll do a pelvic exam. If you have drainage, they’ll take a sample and look at it under a microscope to determine if you have an STI. 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. That’s a disease that affects the lips that surround your vagina.

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 you’re under 40 and your cyst isn’t causing problems, you probably won’t need treatment.

A simple sitz bath may help the cyst go away on its own:

• Fill a tub with 3 to 4 inches of water (enough to cover your vulva), and gently sit.
• Do this several times a day for 3 or 4 days.
• The cyst may burst and drain on its own.

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 three ways:

• Surgical drainage. The doctor will make a tiny cut in the cyst. They’ll place a small rubber tube (catheter) into the opening to allow it to drain. It can stay in place for up to 6 weeks. You’ll 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.
• 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.

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 formation. Good hygiene can also help.

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