An Overview of Bartholin's Cyst

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A Bartholin's cyst, also known as Bartholin's gland cyst and Bartholin’s duct cyst, occurs when a Bartholin's gland—one of two glands responsible for the lubrication of the vagina—get filled up with fluid. The openings of the glands, located at either side of the vaginal entrance, can sometimes get obstructed due to an infection or other cause. When this occurs, the accumulation of fluid with lead to the formation of a cyst.

A Bartholin's cyst doesn't always need treatment, but there are options available if the cyst becomes painful, excessively large, or infected.

Bartholin's cyst treatment
Illustration by Brianna Gilmartin, Verywell

Symptoms

In many cases, a Bartholin's cyst won’t cause any symptoms and may only be discovered while cleaning the genitals or undergoing a pelvic exam. Most cysts are soft and painless and resolve on their own without any problems.

Some women may report feeling an odd ache with movement or during sexual intercourse, while others may not see a physical lump but rather experience a generalized swelling of the vulva.

However, it is possible for the cyst to become infected with bacteria and transform into a pus-filled mass called an abscess. When the occurs, symptoms may include:

  • A swollen, red, painful lump
  • A greenish-yellow drainage from the lump
  • High temperature with chills
  • Generalized aches
  • Malaise (a general feeling of unwellness)

A Bartholin's cyst can sometimes become excessively large and cause discomfort while sitting, walking, or engaging in physical activity or sex. Even if there is no infection, a cyst of this size can still cause pain.

Causes

Bartholin's cysts form when there is a blockage at the opening of a Bartholin's gland. Bartholin's glands are situated to the left and right of the opening of the vagina and secrete mucus to lubricate vaginal tissues. If a blockage occurs, the mucus will back up into the gland and form a cyst.

The cause of the obstruction is often unknown but may include:

  • A bacterial vaginal infection, such as from E. coli
  • Extra-thick vaginal mucus
  • A vaginal injury
  • A sexually transmitted disease like gonorrhea and chlamydia
  • Vulvovaginal surgery

Around 2% of women will develop a Bartholin's cyst at some point in their lives. It is most common in sexually active women between the ages of 20 and 30. The older you get, the less likely you are to develop cysts as the glands will typically shrink and produce less mucus after 30.

Diagnosis

Your doctor will diagnose a Bartholin's cyst with a pelvic exam. The doctor will also ask about your medical history (including your sexual history) and take a sample of mucus to test for chlamydia and gonorrhea.

If you are over 40 and have undergone (or are undergoing) menopause, your doctor may order a biopsy to rule out vulvar cancer as a cause. A biopsy involves removing part of all of the cyst so that the tissues can be examines under a microscope in the lab.

Based on your age and risk of sexually transmitted infections, your doctor may also recommend a blood test to screen for chlamydia, gonorrhea, HIV, and syphilis.

Treatment

If a Bartholin's cyst is asymptomatic (without symptoms), it may not require treatment and will often resolve on its own. However, if there any changes in the size or shape of the cyst, report it to your doctor so that further evaluations can be performed.

Home Remedies and Lifestyle

If a cyst is painful, tender, or causing you discomfort, your doctor may recommend taking a sitz bath several times a day for three to four days. This simply involves soaking the tissues in a tub of warm water to promote drainage or help the cyst rupture.

Never "pop" a Bartholin's cyst as this may only increase the risk of a bacterial infection.

Medications

An over-the-counter analgesic like Tylenol (acetaminophen) or nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) may be recommended to relieve discomfort and inflammation.

If an abscess had formed, your doctor may prescribe an oral antibiotic like Cipro (ciprofloxacin), Rocephin (ceftriaxone), Zithromax (azithromycin), or doxycycline to help resolve the infection.

If you have been diagnosed with chlamydia, you may receive a single oral dose of an oral antibiotic or will need to take a daily course of antibiotics five to 10 days. For gonorrhea, a single intramuscular injection of Rocephin along with an oral dose of Zithromax is generally recommended.

Surgeries and Specialist-Driven Procedures

If the cyst does not resolve after in-home treatment, or your doctor feels that interventions are needed because the cyst is severely infected or especially large, surgery and other interventions may be recommended.

The treatment options include:

  • Needle Aspiration: This can be performed in a doctor's office and involves the insertion of a needle into the cyst to suction out the pus. This option is less commonly pursued because the cyst will likely return.
  • Incisional Drainage: For this approach, the cyst is simply cut and the fluids drained. Recurrence is also common with the procedure.
  • Catheter Insertion: This involves the insertion of a balloon-tipped catheter (called a Word catheter) into the cyst after it has been cut and drained. The catheter is then inflated and left in place for a minimum of four weeks for a permanent opening to form. The recurrence of cysts is unlikely with this method of treatment.
  • Marsupialization: This involves making a small cut into the cyst and, after drainage, stitching the edges of the cut to create a permanent drainage passage. Marsupialization is often performed under general anesthesia and is mainly used for women with recurrent cysts.
  • Excisional Resection: If other surgical methods fail, the surgeon may recommend that the gland be removed entirely. Even if it is, the remaining gland will still produce mucus to help lubricate the vagina.

A newer procedure involves the use of a carbon dioxide laser, which is able to open the cyst and vaporize the contents of the capsule. Its use in treating Bartholin's cysts is controversial and generally avoided if there is an abscess.

A Word From Verywell

Having a Bartholin's cyst is by no means life-threatening. Chances are that your cyst will resolve on its own or respond well to treatments if needed. Surgery is rarely required, but, if it is, can be very effective in treating severe or recurrent cyst formations.

While there is no way to prevent a Bartholin's cyst from forming, practicing safe sex is believed to reduce your risk.

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