What are Bartholin gland cysts?
The Bartholin’s glands are two tiny glands that are located on each side of the vaginal opening. They’re about the size of a pea and they produce the fluids that lubricate the thin skin of the vulva – the outer opening of the vagina.
Occasionally, mucus, swelling, or infection can cause a blockage of the Bartholin’s ducts, causing a Bartholin’s gland cyst. A Bartholin’s cyst may grow gradually and range from a few millimeters to a centimeter in diameter.
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Many of these cysts are painless and will resolve on their own. However, some may cause discomfort and, in some cases, can become infected. An infected Bartholin’s cyst is known as a Bartholin gland abscess and must be treated immediately.
How common are Bartholin gland cysts?
About 2% of individuals assigned female at birth (AFAB) will experience a Bartholin cyst at some point in their lives. These cysts are more common between the ages of 20 and 40, with the risk of developing one decreasing after menopause.
What are the symptoms of Bartholin gland cysts?
Bartholin’s cysts that are not infected will sometimes have no symptoms at all. But some common symptoms include:
- Small, painless bump or a lump under the vulvar skin
- Swelling or redness
- Discomfort while sitting, walking, or during sexual intercourse (dyspareunia)
An infected cyst, also known as an abscess, will present with more severe symptoms. Signs of infection include:
- Swelling, redness, and tenderness in the vulva
- Pain that worsens with time, making it difficult to sit or walk
- Fluid draining from the cyst
- Fever or chills
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.
What causes a Bartholin cyst?
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Healthcare providers don’t know the exact cause or why some people are prone to getting them. However, some possible causes include:
- Injury, irritation, or extra growth of skin in the vulvar area of your vagina.
- Chlamydia, gonorrhea, or other sexually transmitted infections (STIs).
- Bacterial infections such as Escherichia coli (E. coli).
How is a Bartholin cyst diagnosed?
To diagnose a Bartholin cyst, your healthcare provider will perform a pelvic exam to assess the size of the cyst and check for signs of infection. If there is any vaginal discharge, they may test the fluid for sexually transmitted infections (STIs) or other bacteria.
Though uncommon, carcinoma of the Bartholin gland should be considered in women who present with unusual symptoms, or there is suspicion of malignancy. Additionally, if you’re older than 40, your healthcare provider may perform a biopsy to rule out cancer of your vulva.
Treatment of Bartholin gland cysts
Non-infected cysts
Sometimes, self-care home treatment is all you need. Although these cysts often go away on their own, they may be uncomfortable to deal with. Over-the-counter pain relievers, such as ibuprofen (Motrin, Advil, etc), can help with the discomfort. Avoid sex until the cyst has healed.
You can help the cyst heal by soaking in inches of warm water bath, with or without Epsom salt. You can use your regular tub or a sitz bath, which is a basin you can place over your toilet seat and use to soak the genitals. These can be purchased at a pharmacy or medical supply store.
Some women find that applying tea tree oil or witch hazel can help draw the cyst out.
Infected cysts (abscesses)
If you have an infected Bartholin’s gland cyst, you should make an appointment with your healthcare provider. Sometimes, a Bartholin cyst can become infected due to underlying sexually transmitted infections, which would require treatment.
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An infected cyst may rupture on its own and heal within 3-4 days. However, you may also need it drained by your OB-GYN. In addition, you may need to take antibiotics to fight the infection.
To prevent the cyst from reoccurring, your doctor may recommend:
- Drainage tube/balloon. A small tube and balloon can be inserted into the cyst to keep it from clogging up again. The balloon should be removed after the area has healed.
- Carbon dioxide laser treatment
- Silver nitrate application
- Marsupialization. Doctors make a small cut in the cyst and stitch the inside edges of the cyst to the surface of the vulva. This procedure is done in an outpatient operating room. This is when the surgeon creates a pouch over the cyst by making an incision and then pursing the corners together with stitches, allowing the cyst an opening to drain. Sometimes, a local anesthetic is needed.
- Gland excision. In rare cases, a persistent cyst that keeps coming back might need to be treated with surgery. During this surgical procedure, your doctor removes the Bartholin gland and duct to prevent future infections. In some cases, it may need to be done in a surgery center with general anesthesia so that you are asleep and pain-free.
At the very forefront of women’s health in Los Angeles – Dr. Aliabadi
Dr. Thaïs Aliabadi routinely appears among the top OB/GYNs in the country’s physician rankings. This success was earned following years of exacting training and decades of building and nurturing one-on-one relationships with every woman who comes to her practice.
We invite you to establish care with Dr. Aliabadi. Please make an appointment online or call us at (844) 863-6700.
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Sources
Chen KT. Bartholin gland cyst and abscess: Word catheter placement. https://www.uptodate.com/contents/search. Accessed Sept. 11, 2024.
Incidental Bartholin Gland Cysts Identified on Pelvic Magnetic Resonance Imaging – PMC https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3448931/
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