Bartholin’s cyst – NHS

A Bartholin’s cyst, also called a Bartholin’s duct cyst, is a small fluid-filled sac just inside the opening of the vagina.

Symptoms of a Bartholin’s cyst

You may feel a soft, painless lump. This does not usually cause any problems.

But if the cyst grows very large, it can become noticeable and uncomfortable. You may feel pain in the skin surrounding the vagina (vulva) when you walk, sit down or have sex.

The cyst can sometimes affect the outer pair of lips surrounding the vagina (labia majora). One side may look swollen or bigger than usual.

If the cyst becomes infected, it can cause a painful collection of pus (abscess) to develop in one of the Bartholin’s glands.

Signs of an abscess include the affected area becoming red, swollen, tender and hot. It can also cause a high temperature.

When to see a GP

Small Bartholin’s cysts are sometimes only found during a routine cervical screening test or an examination carried out for another reason.

Always see a GP if you develop a lump in the area around your vagina so they can confirm a diagnosis and rule out more serious conditions.

If they think the cyst or one of your Bartholin’s glands may be infected, they may use a swab to remove a sample of discharge for analysis to identify the bacteria responsible.

Sometimes, a GP may recommend you have a biopsy. A small sample of cyst tissue will be removed and examined under a microscope to check for signs of a rare type of vulval cancer called Bartholin’s gland cancer.

What causes Bartholin’s cysts?

The Bartholin’s glands are a pair of pea-sized glands found just behind and either side of the lips that surround the entrance to the vagina.

The glands are not usually noticeable because they’re rarely larger than 1cm (0.4 inches) across.

The Bartholin’s glands secrete fluid that acts as a lubricant during sex. The fluid travels down tiny tubes called ducts into the vagina.

If the ducts become blocked, they can fill with fluid and expand to form a cyst.

It’s often not known why the ducts become blocked, but sometimes it’s linked to sexually transmitted bacterial infections (STIs), such as gonorrhoea or chlamydia, or other bacterial infections, such as Escherichia coli (E. coli).

How Bartholin’s cysts are treated

If you do not have any noticeable symptoms, it’s unlikely you’ll need treatment.

If the cyst is painful, a GP may recommend some simple self-care measures, such as soaking the cyst in warm water several times a day for 3 or 4 days and taking painkillers you can buy from a pharmacy or supermarket.

If these do not work, several treatments are available to treat the pain and any infection. If necessary, the cyst can be drained. Most of these treatments involve a minor surgical procedure.

A Bartholin’s cyst can sometimes return after treatment.

Who’s affected

A Bartholin’s cyst usually affects sexually active women aged 20 to 30.

Bartholin’s cysts do not usually affect children because the Bartholin’s glands do not start functioning until puberty. 

The cysts are also uncommon after the menopause as this usually causes the Bartholin’s glands to shrink.

Preventing Bartholin’s cysts

It’s not clear exactly why Bartholin’s cysts develop, so it’s not usually possible to prevent them.

But as some are thought to be linked to STIs, practising safe sex (using a condom every time you have sex) can help reduce your chances of developing Bartholin’s cysts .

Get more advice about STIs

Page last reviewed: 26 October 2021
Next review due: 26 October 2024

Symptoms, Causes, Diagnosis, and Removing a Bartholin Gland Cyst

Written by WebMD Editorial Contributors

Medically Reviewed by Nivin Todd, MD on November 06, 2022

• Bartholin’s Cyst Symptoms
• Causes of Bartholin’s Cyst
• Bartholin’s Cyst Diagnosis
• Bartholin’s Cyst Treatment
• Bartholin’s Cyst Prevention

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.

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

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.

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.

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.

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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Bartholinitis – causes and types of disease

Causes of bartholinitis

Inflammation in the Bartholin gland is caused by infectious agents that enter it from the vagina or urinary tract. The causative agent of the disease can be gonococcus, Trichomonas or other microorganisms. Cases of spread of infection through the blood are known.

The entry of a pathogen into the gland does not always cause bartholinitis. The onset of the inflammatory process is provoked by various external and internal factors:

• chronic diseases: caries, pyelonephritis, sinusitis and other sources of infection in the body;
• weak immunity against the background of a cold, lack of vitamins, stress, pregnancy;
• damage to the Bartholin gland as a result of surgery, abortion;
• promiscuous and unprotected sexual intercourse, etc.

At the initial stage, inflammation of the mucous membranes occurs. The natural outflow of the secret is blocked – the secretions begin to accumulate in the gland and form a cyst. Gradually education grows. The cyst of the Bartholin’s gland is filled with purulent contents, and an abscess occurs. A woman can feel education on her own. The abscess is located on the labia, looks like a small bump, painful when pressed.

Forms and symptoms of bartholinitis

According to the severity of the course, inflammation is acute and chronic.

Acute bartholinitis begins with canaculitis. Inflammation affects only one gland, so local symptoms are one-sided. Bilateral canaculitis usually occurs when infected with gonorrhea. The patient during this period may not feel acute symptoms. Anxious signs are noticed by the doctor during the examination. Redness appears at the exit site of the gland duct. The channel itself for the discharge of the secret begins to be palpated well. When pressed, a purulent discharge appears from the gland. At the stage of canaculitis, inflammation can be stopped quickly enough. If no action is taken, the swelling will increase and block the duct. Gradually, the inflammation will move to the gland itself.

Acute bartholinitis exists in two forms:

• true abscess. The infectious agent penetrates the body of the gland. Patients complain of severe pain that worsens with movement. Inguinal lymph nodes increase, a large edema is formed. Fever and high body temperature – up to 40 degrees are added to the signs of bartholinitis. Opening an abscess brings only temporary relief. In addition, damage to the cyst with purulent bartholinitis can lead to sepsis, so you can’t squeeze out the bump on your own – it’s life-threatening. At the first signs, it is necessary to enroll in gynecology to receive qualified assistance;
• False abscess (formed during the progression of canaculitis). A woman with bartholinitis complains of an increase in body temperature up to 37.5 degrees, pain in the perineum. One-sided swelling appears on the labia at the location of the abscess. The focus of infection is not in the gland, but next to it. As pus accumulates, the cyst increases in size, becomes painful, and the skin turns red.

Chronic bartholinitis is a consequence of an untreated acute form. Short remissions are replaced by exacerbations. The next cycle, any infection, stress, beriberi, etc. can provoke a relapse. The chronic form is difficult to treat even when the exact cause of inflammation is established.

Subacute bartholinitis is also distinguished, but such a diagnosis is rare. The disease is characterized by the subsidence of acute symptoms and gradually turns into a chronic process.

Bartholinitis during pregnancy

Any inflammation in the female genital organs is a danger to the fetus. That is why pregnant patients should regularly come to see a gynecologist and take tests. Preventing inflammation is much easier than treating it.

During pregnancy, a natural decrease in immunity occurs. The body suppresses defense reactions so as not to reject the fetus, which is 50% genetically alien. Under such conditions, the mother’s body cannot provide a reliable barrier to infection. When it enters the genital tract, the pathogens rise up and reach the uterus. A disease such as bartholinitis threatens intrauterine infection of the fetus through the umbilical cord. Infections cause multiple mutations, interfere with the processes of organogenesis. In critical cases, we are talking about abortion.

Complications can be avoided with early registration in gynecology and timely diagnosis of inflammation. The doctor may already suspect a dangerous situation based on the results of a smear, even before the onset of symptoms. Inflammation is stopped, not allowing it to spread in the genitals. Under medical supervision, women calmly carry the pregnancy to natural childbirth.

Diagnosis of bartholinitis

The doctor begins by taking an anamnesis and examining the patient. Before your appointment, be prepared to answer the following questions:

• the date of the beginning and end of the last menstruation;
• the onset of puberty and intimate life;
• the nature of menstruation;
• number of pregnancies and their outcome;
• the time of onset of the first symptoms and the rate of their increase;
• the nature of the complaints;
• the presence of bad habits, other provoking factors.

After collecting an anamnesis, the patient is examined on a gynecological chair. On the external genitalia, bartholinitis is visible visually. The doctor examines the abscess, takes a smear from the walls of the vagina and a sample of the secretion of the gland. The received materials are sent for laboratory research. Only after receiving the results of the tests, the doctor can confidently diagnose and prescribe treatment for bartholinitis cysts. Analyzes are then taken several more times to monitor the effectiveness of therapy.

Treatment of bartholinitis

Do not try to heal yourself! Compresses, baths, attempts to open and clean the abscess end very badly. Patients often come to the appointment after self-treatment with severe fever, extensive inflammation, which requires urgent hospitalization. Don’t risk your health. Contact your doctor in a timely manner.

In the initial stage, doctors treat bartholinitis without surgery. The patient is selected a scheme of conservative therapy, prescribed antifungal drugs, antibiotics. To normalize the intestinal microflora, you will need products with bifidobacteria and vitamins. Surgical removal of a Bartholin gland cyst is not required. To relieve swelling a little, you can apply a heating pad or any other ice container wrapped in a soft cloth to the inflamed area. For treatment, therapeutic tampons with levomekol, Vishnevsky ointment, saline applications, solutions of chlorhexidine, miramistin are also used.

After removing the exacerbation, sitz baths are prescribed with a weak solution of potassium permanganate (1 sl. L. per 1 liter of water). You can use a decoction of chamomile for the same purpose. Bath time – 20 minutes. After the condition improves, they proceed to physiotherapy.

A woman must strictly follow the doctor’s recommendations – this is the only way to prevent the complications of bartholinitis.

A true abscess requires surgery. Operations on the Bartholin’s gland are carried out by two methods:

• Complete removal – extirpation. The doctor excised diseased tissue, removes the gland along with the focus of inflammation. After the operation, the woman goes through a period of rehabilitation with complete sexual rest;
• Formation of a new gland duct. An incision is made in the tissues to remove the secret. The technique helps to temporarily alleviate the patient’s condition, but the risk of recurrence of bartholinitis is high. The incisions quickly overgrow, a cyst is formed again.

There are more gentle, modern methods of treating bartholinitis in gynecology. An annular catheter is installed in the body of the gland (marsupialization operation). Within 2 months, the catheter performs the functions of a natural duct and promotes secretion. Such an operation is less traumatic, the risk of recurrence is minimal. During the rehabilitation period, a woman undergoes a course of magnetotherapy, UV irradiation.

Expert opinion

Women who regularly come for examinations to the gynecologist can see such a diagnosis in the chart as an asymptomatic course of a Bartholin gland cyst. The doctor does not comment on this situation in any way, does not prescribe pills, the patient begins to worry. But there is no reason to panic. A cyst with asymptomatic treatment does not require any radical measures. Regular monitoring, proper hygiene, balanced nutrition are necessary. The female body, with sufficient support, copes with the stagnation of the secret on its own. Therefore, listen to your doctor and do not self-medicate.

Prevention of bartholinitis

To reduce the risk of inflammation, it is necessary to strengthen the immune system, observe the rules of intimate hygiene, and have sexual relations with one regular partner. It is important to treat gynecological diseases in time and at least once a year undergo a preventive examination by a doctor.

Be careful with your choice of underwear. It should be sufficiently free, elastic, made of natural fabrics. For intimate hygiene, use gels with a neutral pH, without dyes and fragrances. A healthy lifestyle and proper nutrition is the best prevention for most diseases.

The doctors of the Alfa Health Center clinic will help you cope with bartholinitis and restore your women’s health. Call us to make an appointment and find out the price of the consultation.

Sources:

1. Clinical protocol for the diagnosis and treatment of inflammatory diseases of the perineum, vulva, vagina. Electronic version.

2. Bartholinitis. Medical encyclopedia. Electronic version.

Bartholin gland cyst | Center Dikul

Bartholin’s cyst (or vulvar cyst) is a cyst that can form on both sides of the labia, near the entrance to the vagina. The cyst is formed from the Bartholin glands, which produce the mucus needed to lubricate the vagina. The Bartholin glands and labia are part of the female reproductive system.

A Bartholin gland cyst is formed when the outflow of fluid from the opening of the gland is disturbed and mucus accumulates and a tubercle forms. Usually, a cyst develops on only one of the two Bartholin’s glands. Some Bartholin gland cysts are small and do not cause pain. If the cyst becomes infected, then an abscess is formed and pain may appear, and then treatment is required.

Symptoms

In most cases, a Bartholin’s cyst does not cause symptoms and can be detected during hygiene care or after a gynecological examination. Typically, cysts are painless and resolve on their own.

Some women may experience discomfort with movement or during intercourse, while others may experience general swelling of the vulva.

However, the cyst can become infected with bacteria and fester, forming an abscess. When an abscess forms, there may be symptoms such as:

• Presence of red swollen bump
• Greenish-yellow purulent discharge from swelling
• High fever with chills
• Body aches
• General weakness

Bartholin’s cyst in some cases becomes very large and causes discomfort when walking, sitting, having sex. Even if the cyst is not infected, if it is large, it can cause pain.

Causes

A Bartholin gland cyst forms when there is a blockage in the orifice of the Bartholin gland. The Bartholin glands are located to the left and right of the entrance to the vagina, and they produce mucus that lubricates the tissues of the vagina. With blockage, mucus cannot leave the gland and a cyst forms.

Causes of blockage are not always known, but may include:

• Bacterial vaginal infection, such as E. coli.
• Thick consistency of vaginal mucus
• Injuries of the vagina
• STDs such as chlamydia and gonorrhea
• Surgical vulvovaginal procedures

Statistics show that 2% of women develop a Bartholin gland cyst during their lifetime. The cyst most often forms in sexually active women between the ages of 20 and 30. As age increases, the risk of developing a cyst decreases, as there is a gradual decrease in Bartholin’s glands and a decrease in mucus secretion.

When should I see a doctor?

A woman should contact her doctor if she develops a painful lump near the entrance to the vagina that does not go away after two or three days of self-care, such as soaking the area in warm water (sitz bath). If the pain is severe, you should immediately make an appointment with a doctor.

You should also contact your doctor immediately if a woman finds a new tumor near the entrance to the vagina and she is over 40 years old. Although such a tumor is rare, it can be a sign of a more serious problem, such as cancer.

Diagnosis

A doctor diagnoses a Bartholin’s cyst during a gynecological examination. The doctor will also take a medical history and take a mucus sample to check for infections such as gonorrhea and chlamydia.

If the woman is menopausal or postmenopausal, her doctor may recommend a biopsy to rule out vulvar cancer. During a biopsy, a part of the cyst is taken for examination of the tissue in the laboratory under a microscope.

Depending on the woman’s age and the risk of sexually transmitted infections, the doctor may recommend laboratory tests (blood tests for infections such as chlamydia, gonorrhea, syphilis, HIV).

Treatment

If a Bartholin’s cyst does not cause symptoms, then treatment may not be required as it may disappear on its own. However, if a woman notices an increase in the size or change in the shape of the cyst, then she needs to see a doctor.

If the cyst is painful or uncomfortable, your doctor may recommend warm sitz baths several times a day for three to four days. This may improve drainage and rupture of the cyst.

Women are advised not to open the cyst themselves, as this greatly increases the risk of infection.

Medications

Analgesics such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may be recommended to reduce inflammation and pain.

If an abscess has formed, your doctor may prescribe an oral antibiotic such as cipro (ciprofloxacin), rocefin (ceftriaxone), zithromax (azithromycin), or doxycycline to help clear the infection.

If a woman is diagnosed with chlamydia, either a single dose of an antibiotic or a course of treatment can be prescribed. For gonorrhea, a single intramuscular injection of Rocephin (ceftriaxone) is usually recommended. If chlamydia is not ruled out, oral doxycycline (100 mg twice daily for seven days) is recommended.

Specialized Procedures

If the cyst does not resolve after home treatment or the cyst is infected and large, the doctor may prescribe surgical procedures.

Treatment options include:

• Needle aspiration: This procedure can be performed on an outpatient basis and involves inserting a needle into the cyst to suck out pus. This procedure is rarely used because of the high risk of recurrence.
• Incisional drainage: This procedure involves cutting the cyst and draining the fluid. After that procedure, there are also relapses.
• Insertion of a catheter. This procedure involves inserting a balloon catheter into the cyst after it has been incised and drained.