An Overview of Bartholin's Cyst

A Bartholin's cyst, also known as Bartholin's gland cyst or a Bartholin’s duct cyst, occurs when a Bartholin's gland—one of two glands responsible for the lubrication of the vagina—fills 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 will lead to the formation of a cyst.

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

This article will explain the symptoms and causes of a Bartholin's cyst and how they are treated.

Bartholin's Cyst 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 uncomfortable ache with movement or during sexual intercourse. 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 become a pus-filled mass called an abscess. When this 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)

Bartholin's Cyst Causes

The cause of a Bartholin's cyst 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 or chlamydia
• Vulvovaginal surgery

Around 2% of women will develop a Bartholin's cyst at some point in their lives. It's 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 healthcare provider will diagnose a Bartholin's cyst with a pelvic exam. They 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 are going through (or have gone through) menopause, your healthcare provider 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 examined under a microscope in the lab.

Based on your age and risk of sexually transmitted infections, your healthcare provider 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 it is painful or uncomfortable, treatments may include:

Sitz Baths

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

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 has formed, your healthcare provider 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 antibiotic or will need to take a daily course of antibiotics for seven days. For gonorrhea, a single intramuscular injection of Rocephin (ceftriaxone) is generally recommended. If chlamydia has not been excluded, then an oral dose of doxycycline (100 mg twice daily for seven days) is necessary.

Surgeries and Specialist-Driven Procedures

If the cyst does not resolve after in-home treatment or your healthcare provider 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 healthcare provider'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 this 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: A small cut is made into the cyst. After it drains, the edges are stitched together 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, a 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.

Summary

When one of the Bartholin's glands—the glands on either side of the vaginal opening that are responsible for lubricating the vagina—becomes blocked, the gland can fill up with fluid, causing a cyst to form.

Bartholin's cysts are often caused by an infection and can be uncomfortable or painful. Most of the time, these cysts go away on their own. In some cases, however, surgery is required to drain or remove the cyst and prevent them from forming again.

A Word From Verywell

Having a Bartholin's cyst can be uncomfortable, but it is very rarely serious. Chances are that your cyst will resolve on its own or respond well to treatments if needed.

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