What is a Bartholin’s cyst?
A Bartholin's cyst happens when 1 or both of a pair of small glands found next to the opening of your vagina get blocked and fill up with mucus. These glands are called Bartholin’s glands and are usually the size of a pea. Their main role is to make a fluid that keeps your vaginal entrance (vulva) moist.
You usually can’t see or feel these glands, but if they become blocked, they can swell up to form a Bartholin’s cyst.
Bartholin’s cysts usually don't hurt, but if they get infected they can become painful and may turn into an abscess (a collection of pus).
Bartholin’s cyst symptoms
If you have a Bartholin’s cyst, you may notice a soft, painless lump near the opening of your vagina. It usually only affects 1 gland, so you’ll notice a lump on just 1 side.
The lump may be small or large, and it may get bigger or stay the same size.
If the lump grows quite large, it may stop you from doing things like walking, sitting and having sex as you normally would.
A Bartholin’s cyst shouldn’t hurt. If it does, you may have an infection that needs to be treated.
When to see a doctor
Many things can cause a lump in or around your vagina – some more serious than others. If a lump suddenly appears, see a doctor as soon as possible.
You should go to hospital or the emergency department immediately if:
- the lump feels very painful, red, hot and/or tender
- the lump is so painful you can’t do normal activities like walking and sitting down
- the lump suddenly becomes bigger – often over a few hours or days
- you can see pus building up in the lump or leaking out of it
- you have a fever or feel unwell
- you have unexpected blood or unusual discharge coming from your vagina (foul smelling or a strange colour)
- you have pelvic and/or lower tummy pain
What causes a Bartholin’s cyst?
While Bartholin’s cysts are caused by a blockage in 1 of your Bartholin’s glands, it’s not clear why this blockage happens.
Less often, a Bartholin’s cyst may be caused by a sexually transmitted infection (STI), physical damage around your vagina, or mucus or fluid build-up around the gland.
How is a Bartholin’s cyst diagnosed?
A doctor will usually suspect you have a Bartholin’s cyst based on your symptoms and looking at the area around your vagina.
You usually won’t need tests, but in some cases, a doctor may take a swab of fluid from the cyst to check for an infection. They may also take a small sample of tissue (a biopsy) from the lump to rule out other causes of the swelling.
What is the treatment for a Bartholin’s cyst?
If the cyst is small and isn’t causing you any pain or symptoms, you usually won’t need any treatment because Bartholin’s cysts tend to get better on their own in time.
But if the cyst is causing pain and discomfort, a doctor may suggest a few things you can do at home to relieve this, including:
- taking simple painkillers – speak to a doctor or pharmacist about the best ones for you and how to safely take them
- soaking the area in warm water for 10 to 15 minutes (called a sitz bath) – do this a few times a day
- using a warm compress on the area, like a facecloth warmed with hot (but not boiling) water
If these self-care measures don’t work, you may need medical treatment, including antibiotics if you have an infection and an abscess develops, or a procedure to drain the cyst. And if the cyst keeps coming back, in some cases, you may need surgery to remove the gland.
Procedures for treating a Bartholin’s cyst
A doctor will make a small cut in the cyst to drain any fluid in it. They’ll then insert a tube (catheter) with a small balloon on its end into the cyst before using a little bit of salt water to inflate the balloon. You’ll need to leave the catheter in place for around 4 weeks, so a permanent opening has time to form. Once this happens, you’ll see the doctor again to have the catheter removed.
Catheter insertion is usually done in hospital as an outpatient, but you typically won’t need to be put to sleep – the area can be numbed (with a local anaesthetic) instead, so you can’t feel the procedure while it’s being done.
You should be able to do your normal daily activities while the catheter is in place, but sex may feel uncomfortable.
Marsupialisation of a Bartholin’s cyst
Marsupialisation is a procedure that doctors use to make a permanent opening in the cyst, allowing it to drain. It involves making a small cut in the cyst and sewing its edges to nearby skin to make a small pouch.
Like catheter insertion, marsupialisation is usually done in hospital as an outpatient. But you may need to be put to sleep for it (with a general anaesthetic) – although it can also be done using a local anaesthetic.
It’s important to give yourself time to heal properly after this procedure, so you should avoid having sex until the wound has healed fully.
Removal of a Bartholin’s gland
While it’s less common, in some cases a doctor may recommend that the affected gland should be removed. This is more likely if the cyst keeps coming back or doesn’t go away after trying all other treatments.
You’ll usually be put to sleep for the operation and you may have to stay in hospital for a few days afterwards.
You’ll also need to avoid having sex, using tampons and using scented bubble baths for 4 weeks after surgery.
What can I expect after having a Bartholin’s cyst?
Bartholin’s cysts tend to get better on their own or with treatment, but they can come back. This is more likely if you don’t have a procedure to open up the cyst or gland.
There isn’t much you can do to reduce your risk of getting another Bartholin’s cyst in the future, as it isn't clear why most Bartholin’s cysts happen in the first place. But a small number of cases can be caused by an STI, so practising safer sex by using condoms, for example, and getting treated for STIs may help reduce your chances of developing a Bartholin’s cyst from an infection.
Speak to a doctor if your symptoms keep coming back as they should be able to suggest other treatments that may help.
It’s also worth getting familiar with how to do a vaginal self-exam, so you can regularly check for any changes to its appearance. If you do notice any changes, see a doctor.
Your questions answered
What comes out of a Bartholin’s cyst?
A Bartholin’s cyst usually has fluid or mucus in it, but if it becomes infected, it can fill up with pus. If the wall of the cyst breaks, this fluid or pus can come out of it. But you should never try to burst a Bartholin’s cyst yourself. Instead, see a doctor as soon as you notice a lump in the area around your vagina. – Answered by Dr Adiele Hoffman from the Healthily Medical Team
Can a Bartholin’s cyst be caused by stress?
Stress isn’t a known cause of Bartholin’s cyst. In fact, the cause of most Bartholin’s cysts isn’t known, although some cases can be caused by an infection, physical damage to the vagina and area around it, and fluid or mucus build-up around a Bartholin’s gland.
Is a Bartholin’s cyst a symptom of cancer?
A Bartholin’s cyst isn’t usually caused by cancer, but it’s possible – although rare – to develop cancer in a Bartholin’s gland. If this happens, you may notice a lump around your vaginal opening, which may be mistaken for a Bartholin’s cyst. While this is rare, it’s important to see a doctor if you develop a lump you think is a Bartholin’s cyst. They will be able to check the lump and rule out other causes.
- Bartholin’s glands are pea-sized glands at the entrance of your vagina, which make a fluid that keeps your vaginal entrance (vulva) moist
- if these glands become blocked, you may develop a Bartholin’s cyst – a small, painless lump
- Bartholin’s cysts usually get better on their own or with self-care measures like sitting in a warm bath and using a warm compress
- if self-care measures don’t work, you may need medical treatment, including antibiotics if you have an infection, or a procedure to drain the cyst
- Bartholin’s cysts can come back again in the future