The Bartholin’s glands are located on each side of the vaginal opening. They’re about the size of a pea. They produce fluid that keeps the vagina moist.
The fluid travels to the vagina through ducts (tubes). If they become 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 non-cancerous.
What Causes It?
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.
What Are the Symptoms?
You may not have any, unless the cyst is large or becomes 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.
You might also have fever and an unusual vaginal discharge.
How Do I Know If I Have a Bartholin’s Cyst?
Only your doctor can tell you for sure. He’ll do a physical exam. He’ll also likely take a sample of your vaginal discharge and look at it under a microscope. This will reveal whether you have an STI. If you have an abscess, he’ll take a culture of it and send it to a lab.
What’s the Treatment?
If your exam shows that you have an STI, or if your cyst is infected, your doctor will prescribe an antibiotic. He may also prescribe topical medications.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. Simply 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 three or four 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. He’ll treat it in one of three ways:
Surgical drainage. Your doctor will make a small cut in the cyst. He’ll then 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 has been drained. But you may need to take oral pain medication for several days afterwards. 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. Your doctor cuts the cyst to open it. He then stitches the skin around the cyst to form a small pouch. This allows the fluid to drain out. He packs the area with special gauze to soak up the fluid and any blood. The whole 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.
Removal of 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 and you’ll receive anesthesia so you’re not awake for it. Many patients are able to go home after the procedure.
Some possible problems include bleeding, bruising, and infection.