What is a Bartholin’s cyst?
A Bartholin’s cyst is a soft, fluid-filled lump that can form just inside the opening of your vagina. About 2% of women will get a Bartholin’s cyst or abscess in their lifetime.
The Bartholin’s glands are 2 small, round sacs on either side of your vaginal opening. Sitting deep under the skin, you can’t normally feel them. Their job is to keep your vagina moist and provide extra lubrication during sex.
A cyst can form if the duct leading from one of your Bartholin’s glands becomes blocked, leading to build-up of fluid.
What does a Bartholin’s cyst look like?
If you have a Bartholin’s cyst, you may be able to see and/or feel a lump near the opening of your vagina.
They usually only affect 1 gland, so 1 of your vagina’s outer lips (labia majora) may look swollen, lopsided or bigger than usual.
Bartholin’s cysts can be as small as a pea or grow as big as a golf ball, and sometimes even larger.
What causes a Bartholin’s cyst?
In most cases, it isn’t clear why the duct becomes blocked, causing fluid to build up and the lump to form.
However, you’re more likely to get a cyst if:
- you’re of child-bearing age – the Bartholin’s glands don’t function properly until after , so cysts don’t usually happen before this. They’re then more common as you get older, but become less common after the , as hormone changes cause the glands to shrink
- you’re sexually active – friction during sex can block the Bartholin’s duct. Rarely, cysts can also be caused by a
- you’ve had physical damage to your vagina – such as during childbirth
- you’ve had a bacterial infection – such as
Can a Bartholin’s cyst be caused by stress?
There’s no proven connection, though anecdotally some people believe Bartholin’s cysts are linked to stress.
If you’re feeling overwhelmed, it’s worth thinking about
, as stress can have a big effect on your body.
Why do I keep getting Bartholin’s cysts?
Some people get recurring Bartholin’s cysts. There isn’t usually a clear reason for this, but you may need
from your doctor to stop them coming back.
What causes a Bartholin’s gland abscess?
If a Bartholin’s cyst gets infected, it may turn into a painful collection of pus called an
.
It’s thought that this can happen if bacteria that normally live in your vagina infect the cyst, or because of an STI, such as
or
.
Bartholin’s cyst symptoms
If you have a small Bartholin’s cyst, you may not even know it’s there – they often don’t cause any symptoms.
If the cyst is larger, you might be able to feel a soft swelling or lump on 1 side of your vagina.
If a cyst has grown, symptoms may include:
- discomfort, pressure and/or pain, which is worse when you’re sitting down or walking
- pain during sex
How can I tell if it’s a Bartholin’s cyst or an abscess?
It can sometimes be difficult to tell the difference. But key signs that you have an infected cyst that might need
include:
- the lump is red, or the surrounding area is swollen
- the skin or lump is painful and hot to touch
- the lump is growing quickly – an abscess can get bigger over hours or days
- there’s fluid leaking from the lump, which might smell
- you feel unwell or have a high temperature (fever)
- it’s painful or stings when you pee
Self-care for Bartholin’s cysts
If the cyst isn’t giving you any trouble, you may not need treatment. But if it’s uncomfortable or painful, these simple self-care measures can help:
- soaking the cyst in warm water – such as in the bath. Doing this for 10 to 15 minutes several times a day, for 3 or 4 days, can relieve tenderness and help it to burst
- applying a warm (but not hot) compress – such as a face cloth
- taking painkillers – such as acetaminophen () or , which you can buy from a pharmacy or supermarket
How to burst a Bartholin’s cyst at home
“You should never try to burst a Bartholin’s cyst at home using any kind of squeezing or force,” says Dr Adiele. “This could cause infection and scarring.”
Soaking the cyst regularly may help it to burst naturally. And if the cyst becomes infected, the abscess may burst and release pus. If this happens, be sure to keep it clean until it heals.
If a Bartholin’s cyst bursts by itself, your symptoms will normally improve on their own. But
. If you’re not sure, it’s best to get it checked out.
If self-care measures don’t help, you may need medical treatment.
When to see a doctor
Most vaginal lumps are harmless. But if you notice one, see a doctor to find out what’s causing it. Your doctor can help diagnose you, and treat a Bartholin’s cyst if necessary.
When to see a doctor urgently
If you develop symptoms of a Bartholin’s abscess, you should get them checked by a doctor right away. These include if:
- the lump feels very painful, red, hot and tender
- you can’t do normal things such as walking and sitting down
- the lump suddenly becomes much bigger – over a few hours or days
- pus is building up in the lump or leaking out of it
- you get a stinging sensation when you pee
- you have unusual or smelly vaginal discharge
- you have a high temperature (fever) or you feel unwell
- you have pelvic and/or lower tummy pain
You should also see a doctor as soon as possible if you’ve been taking antibiotics for a lump and it isn’t improving or it’s getting worse.
When to get emergency medical help
If you feel very unwell, you might be having a rare reaction to infection called
, which can be life-threatening.
Symptoms include:
- a very high or low temperature
- fast heart rate
- feeling confused or drowsy
If you have a combination of these symptoms, call an ambulance or go to the nearest emergency department.
How will a doctor diagnose a Bartholin’s cyst?
Your doctor will ask you about your symptoms, and ask to look at the area around your vagina.
You won’t usually need any tests. But if your doctor thinks the cyst is infected, they may take a swab of fluid for testing.
If you’re at risk of an STI, they might also suggest you have a swab test higher up in your vagina.
In some cases, they may also take a small sample of tissue (
) from the lump to rule out other causes, including a rare type of
called Bartholin’s gland cancer.
What is the treatment for a Bartholin’s cyst?
If self-care hasn’t helped or your doctor thinks you have an abscess, they may give you
– though these aren’t always needed.
If antibiotics don’t work for the abscess, or the cyst is very big, you may need a small surgical procedure to drain the fluid.
You may also need 1 or more of the following procedures to stop it coming back.
Catheter insertion
This is often the first treatment your doctor will try.
What happens:
- your doctor makes a small cut in the cyst to drain any fluid, then inserts a tiny tube (catheter) with a small inflated balloon at the end
- this stays in place for 4 to 6 weeks, to help create a permanent opening to prevent fluid collecting and to stop the cyst coming back
- you’ll then see your doctor again to have the catheter removed
What you need to know:
- the insertion takes 5 to 10 minutes
- the area can be numbed with a so you won’t feel anything
- you should be able to go home within 1 hour
- your doctor may suggest you take pain relief before and after the procedure
- soaking the area in warm water several times a day for a few days can help ease any discomfort
- you should be able to go back to your normal life after 3 days, including exercising and having sex – although sex might feel uncomfortable with the catheter in place
- some discharge is normal for a few weeks afterwards
Marsupialization (drainage) of Bartholin’s cyst
What happens:
- a doctor who specializes in women’s health (gynecologist) makes a permanent opening in the cyst so it can drain
- they make a small cut, then sew the edges to nearby skin to stop it refilling
- the cut is kept open with dissolvable stitches, so you won’t need to go back to hospital to have them removed
What you need to know:
- the procedure takes about 15 minutes
- it can be done with a local anesthetic, or you may be put to sleep with a
- you’ll probably need pain relief afterwards, such as paracetamol or ibuprofen
- soaking the area in warm water can help speed up healing
- you should rest for a few days to give yourself time to heal, and avoid having sex until the wound has completely healed
- you should avoid bubble baths or wearing tight-fitting clothes while the wound is healing
- some discharge is normal for a few weeks afterwards
Removal of a Bartholin’s gland
It’s less common, but in some cases your doctor may recommend removing the affected Bartholin’s gland.
Removal is more likely if:
- you’re over 40
- your cyst is larger than 5cm
- it keeps coming back after trying other treatments
What you need to know:
- the surgery takes about 1 hour
- it’s usually done under general anesthetic
- you may need to stay in hospital for 2 or 3 days afterwards
- you may be advised to avoid having sex and using tampons for up to 4 weeks, to help the wound heal and reduce the risk of infection
- you should avoid using perfumed bath products for up to 4 weeks
Will a Bartholin’s cyst come back?
Unfortunately, Bartholin’s cysts can come back. And as it isn’t clear why they happen, there’s not much you can do to prevent them.
Because a small number of cysts are caused by STIs, practising
– by using
and getting tested and treated for any STIs – may help reduce your risk.
And if you’re not sure what’s normal for you, get in the habit of doing a regular
, so you can check for any changes.
Your health questions answered
What comes out of a Bartholin’s cyst?
“A non-infected Bartholin’s cyst contains sterile fluid, is around the size of pea and makes a natural lubricant for sex,” explains Dr Adiele. “But if the cyst becomes infected, this fluid is replaced with pus and becomes an abscess.”
Is a Bartholin’s cyst a symptom of cancer?
“In very rare cases, a lump in the same place as a Bartholin’s cyst may be a type of vulval cancer called Bartholin’s gland cancer,” says Dr. Adiele. “It usually only happens in women over 40. If your doctor has any concerns, they’ll do a biopsy – which means taking a small sample from the cyst – which will allow them to rule out anything more serious. This is usually for irregular lumps that don’t go away.”