Bartholin’s cyst is a common condition that affects women and occurs when one of the Bartholin’s glands, located near the opening of the vagina, becomes blocked and fills with fluid. This fluid can build up, causing a swelling that can become uncomfortable or painful. According to estimates, around 2% of women will experience a Bartholin’s cyst at some point. The condition usually affects sexually active women between the ages of 20 and 30. Fortunately, the condition is usually treatable, and with proper care and attention, most women can make a full recovery.
Bartholin’s glands: The Bartholin’s glands are a pair of pea-sized glands that are found just behind and either side of the labia minora. The glands are not usually noticeable because they are rarely larger than 1cm (0.4 inches) across.
The Bartholin’s glands secrete fluid that acts as a lubricant during sexual intercourse. The fluid travels down tiny ducts that are about 2cm (0.8 inches) long into the vagina. If the ducts become blocked, they will fill with fluid and expand. This then becomes a cyst.
Symptoms of a bartholin’s cyst
Most Bartholin’s cysts do not cause any symptoms. However, you may feel a soft, painless lump in your labia.
You may not know that you have a cyst until it is found by a healthcare professional during a routine cervical screening test (smear test) or another gynaecological examination. A gynaecologist is a specialist in treating conditions of the female reproductive system.
If the cyst grows very large, it can become uncomfortable and noticeable. You may experience pain in your vulva at certain times such as:
- during sexual intercourse,
- when walking, or
- when sitting down.
Sometimes, the cyst can affect the labia majora. One side may look swollen or bigger than usual.
Abscess: An abscess is a painful collection of pus. If the cyst becomes infected, it can cause an abscess. This will be inflamed and tender to touch. It can cause a high temperature of 38°C (100.4°F) or above.
Causes of a Bartholin’s cyst
A bartholin’s cyst is caused by an obstruction that blocks the duct leading from the Bartholin’s gland into the vagina. This leads to a build-up of fluid, which can turn into a cyst.
Several different types of bacteria can cause an infection that blocks the duct. Some types of bacteria can be passed on through sexual contact while others are found in the environment.
Bacteria that may cause a Bartholin’s cyst include:
- Gonococcus: usually responsible for gonorrhoea (a sexually transmitted infection) and may be responsible for around a third of Bartholin’s cysts.
- Chlamydia trachomatis: usually responsible for chlamydia.
- Escherichia coli: often responsible for food poisoning.
- Streptococcus pneumoniae: responsible for pneumococcal infections, such as infections of the inner ear or sinuses.
- Haemophilus influenzae: responsible for a number of infections such as epiglottitis, an infection of the epiglottis
A bartholin’s cyst can also happen for a variety of reasons, including:
- Trauma or injury to the area: Any type of trauma or injury to the vaginal area, such as childbirth or pelvic surgery, can increase the risk of developing a Bartholin’s cyst.
- Hormonal changes: Hormonal changes that occur during pregnancy, menopause, or hormonal imbalances can increase the risk of developing a Bartholin’s cyst.
- Genetics: There may be a genetic component to Bartholin’s cysts, as some women may have a genetic predisposition to developing the condition.
Diagnosing a Bartholin’s cyst
Diagnosis of a Bartholin’s cyst usually requires a physical examination by your doctor or healthcare provider. If you have other symptoms, such as vaginal discharge, your doctor may also advise that you have further tests to diagnose any possible sexually transmitted infections (STIs).
Your doctor may take a sample of your urine or blood, or may take a swab from your genital area. A swab looks a bit like a cotton bud, but it is smaller, soft and rounded. It is used to collect a sample of cells that can then be tested for any infections.
Alternatively, your doctor may refer you to a sexual health clinic and these tests will be carried out there.
If you have started the menopause, you may be advised to have a biopsy of the cyst. A biopsy is a medical procedure that involves taking a small sample of tissue so that it can be examined under a microscope.
If you have started the menopause and you notice a swelling in your vagina, see your doctor or healthcare provider.
Treating a Bartholin’s cyst
Treatment for Bartholin’s cysts varies depending on the size and severity of the cyst, as well as the overall health of the woman. Some common treatments include:
- Home remedies: For small cysts that are not causing significant discomfort, home remedies such as warm sitz baths or over-the-counter pain relievers may be effective in reducing pain and swelling.
- Drainage: If the cyst is larger or causing significant discomfort, drainage may be necessary to remove the fluid from the cyst. This procedure can be performed in a doctor’s office and typically involves a local anesthetic.
- Antibiotics: If the cyst becomes infected, antibiotics may be necessary to treat the infection.
- Surgery: In some cases, surgery may be necessary to remove the cyst or create a new drainage duct. This procedure is typically done under general anesthesia and involves making a small incision in the cyst to allow the fluid to drain. In some cases, the entire cyst may be removed.
It is important to note that treatment for Bartholin’s cysts may need to be repeated if the cyst recurs, and in some cases, additional treatments or procedures may be necessary. Women should work closely with their healthcare provider to determine the best treatment plan for their individual needs.
Complications of a Bartholin’s cyst
While Bartholin’s cysts are generally not serious, they can lead to certain complications if left untreated or if the cyst becomes infected. Some of the most common complications associated with Bartholin’s cysts include:
- Infection: If the cyst becomes infected, it can cause pain, swelling, and redness in the affected area. In severe cases, the infection can spread to surrounding tissues and cause additional complications.
- Recurrence: In some cases, the cyst may recur after treatment, requiring additional drainage or surgical procedures.
- Abscess formation: If the cyst becomes infected and is not treated promptly, it can develop into an abscess, which is a painful, swollen area filled with pus. Abscesses can be difficult to treat and may require surgical drainage.
- Scarring: Surgical procedures to treat Bartholin’s cysts can result in scarring in the affected area, which can lead to pain and discomfort.
- Interference with sexual activity: In severe cases, Bartholin’s cysts can interfere with sexual activity, causing pain and discomfort during intercourse.
It is important to note that these complications can generally be prevented or minimized by seeking prompt medical attention and following a recommended treatment plan.
Preventing a Bartholin’s cyst
While it is not always possible to prevent a Bartholin’s cyst, there are steps that can be taken to reduce the risk of developing one:
- Practice good hygiene: Regular washing and cleansing of the vaginal area can help reduce the risk of infection and minimize the risk of developing a Bartholin’s cyst.
- Avoid irritants: Avoid using harsh soaps, powders, or other irritants in the vaginal area, as these can increase the risk of developing a cyst.
- Use protection during sexual activity: Using condoms and other forms of protection during sexual activity can help reduce the risk of infection and minimize the risk of developing a Bartholin’s cyst.
- Maintain good overall health: Eating a healthy diet, getting regular exercise, and managing stress can help maintain overall health and reduce the risk of developing a Bartholin’s cyst.
- Seek prompt medical attention: If symptoms of a Bartholin’s cyst develop, seek prompt medical attention to ensure that the cyst is properly treated and prevent the risk of complications.