What Is a Bartholin's Cyst?

Bartholin's cysts—sometimes known as Bartholin cysts or Bartholin gland cysts—occur when a buildup of fluid or mucus forms a lump in one of the Bartholin's glands. Those glands are found on either side of the vaginal opening, but you usually can't feel them. Bartholin's glands create the fluid that moistens the vulva.

When fluid builds up in one of the glands, it causes the opening of the duct to be blocked. This can lead to an infection. Fluid in one of your Bartholin's glands can build up over the course of many years before the cyst appears. Sometimes, though, it can happen over several days.

Bartholin's cysts are relatively common. Here's what you need to know about them, including symptoms, causes, and treatment options.

Symptoms

You may not even notice a smaller Bartholin's cyst, but if it grows large enough, it can feel like a lump near your vaginal opening, usually only on one side. If the cyst grows larger or becomes infected, you may have the following symptoms:

• Swelling and redness
• Pain with sitting or walking
• Pain with sexual intercourse
• Vaginal discharge or vaginal pressure

In severe cases, an infected cyst can become an abscess, which is a serious infection that can cause a fever and requires immediate care.

Causes and Risk Factors

Bartholin's cysts form when there is a blockage at the opening of a Bartholin's gland. If a blockage occurs, the mucus will back up into the gland and form a cyst.

The reasons this happens are 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
  

Diagnosis

A healthcare provider can confirm if you have a Bartholin's cyst simply by doing a pelvic exam, which will reveal whether one of your Bartholin's glands is tender and enlarged.

If you are sexually active, they may take a sample of the fluid to test for an STD such as gonorrhea.

For people 40 and older, a healthcare professional may suggest a biopsy. This involves removing part of the cyst or the entire cyst and testing it for cancer cells. A provider may also suggest a biopsy for people younger than 40 if a provider suspects cancer. Though rare, a new lump may be a sign of vulvar cancer.

Treatment

Usually, a small, uninfected Bartholin's cyst won't need treatment, but if it's larger or infected, there are several treatment options.

Treatment options include:

• Soaking the area. You can help ease the discomfort and help the cyst drain on its own by soaking it in a warm water tub (or a "sitz bath") four times a day for several days.
• Needle Aspiration: With this, a needle is inserted into the cyst to remove the fluid.
• Incisional Drainage: For this approach, an incision is made into the cyst, and the fluids are drained.
• Catheter Insertion: A Word catheter is inserted 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.
• Marsupialization: This is a minor surgery when an opening is created to allow for cyst gland drainage and abscess removal. It is often performed under general anesthesia and is mostly used for people with recurrent cysts.
• Excisional Resection: If other surgical methods fail, it may be necessary to remove the cyst entirely.
• Laser surgery: This procedure is done with a CO2 laser. It is directed at the cyst to make an incision and then drain the cyst. While research has found this to be an effective technique, it is not commonly used in the United States due to lack of availability and expense.

A Quick Review

A Bartholin's cyst is a fluid-filled lump in one of the Bartholin's glands that is part of a person's vulva. Though these cysts are rarely serious, they can become infected and painful, making it uncomfortable to sit down or have sex. It is not clear exactly what causes them.

Though there's no real way to prevent Bartholin's cysts, there are several ways to treat them, ranging from soaking the area in a warm bath to having them surgically removed.