Bartholin’s Cyst and Abscess: Causes, Symptoms, and Treatment
A Bartholin’s cyst is a fluid-filled swelling that develops near the vaginal opening. It happens when the Bartholin’s gland duct gets blocked. If the cyst becomes infected, it can form a painful abscess. Though uncomfortable, both conditions are treatable and usually not serious, especially when addressed early.
What Is a Bartholin’s Cyst?
The Bartholin’s glands are two small glands located on each side of the vaginal opening. Their role is to produce fluid that helps lubricate the vaginal area. Normally, this fluid drains through small ducts. When one of these ducts becomes blocked, fluid backs up and forms a cyst.
Cysts can vary in size. Some are no bigger than a pea, while others can grow to the size of a marble or larger. Many are painless and go unnoticed. But if the fluid inside becomes infected, it can result in a swollen, painful abscess that requires prompt treatment.
Symptoms to Watch For
Symptoms differ depending on whether the cyst is infected or not:
Cyst (not infected):
• Small lump or swelling near the vaginal opening
• Generally painless
• May feel pressure or discomfort when walking, sitting, or having sex
• Often discovered during a routine physical exam
Abscess (infected cyst):
• Painful, red, and swollen lump near the vaginal opening
• Increasing discomfort that escalates quickly over hours
• Difficulty walking, sitting, or engaging in daily activities
• Fever, chills, or general malaise (in some cases)
• Spontaneous drainage of pus or foul-smelling fluid if the abscess ruptures
Any sudden pain, swelling, or change in the vulvar area should be assessed by a healthcare professional to rule out infection or other conditions.
When It Becomes an Abscess
A Bartholin’s cyst becomes an abscess when it gets infected. This usually happens when bacteria enter the cyst through the duct opening or nearby skin. Common bacteria include:
• E. coli
• Staphylococcus aureus
• Sexually transmitted bacteria like gonorrhoea or chlamydia
Abscesses can grow rapidly and become extremely painful, so early treatment is key. If untreated, they may rupture on their own, but this can be messy and may not fully resolve the infection.
Treatment Options
Treatment depends on the size of the cyst, whether it’s infected, and if it recurs.
Home Care
For small, non-infected cysts, conservative treatment may be enough:
• Warm sitz baths: Soak in a few inches of warm water for 10–15 minutes, 3–4 times a day. This can help the cyst open and drain on its own.
• Over-the-counter pain relief: NSAIDs like ibuprofen or paracetamol can help reduce pain and inflammation.
Medical Drainage
If the cyst becomes an abscess or is too painful:
• Incision and drainage: Your doctor will numb the area and make a small cut to release the fluid or pus.
• Word catheter placement: A small tube with a balloon tip is inserted to keep the duct open and allow continuous drainage over a few weeks. This reduces the chance of recurrence.
Antibiotics may be prescribed if the abscess is severe, recurrent, or associated with an STI.
Surgical Options
In recurrent or stubborn cases, more permanent solutions may be needed:
• Marsupialisation: The cyst is opened and the edges of the skin are stitched to create a permanent drainage opening. This allows the gland to continue functioning while reducing blockage risk.
• Gland removal (Bartholin’s gland excision): Rarely needed but considered if other treatments fail or cysts keep returning.
A Bartholin’s cyst or abscess can be painful and frustrating, but it’s treatable with the right care. Don’t ignore new lumps or swelling in your vaginal area.
Book a gynaecology consultation if you have a painful lump or swelling near the vaginal opening, especially if it is getting larger, causing discomfort, or associated with fever.
FAQs
Can a Bartholin’s cyst come back?
Yes. Bartholin’s cysts can recur if the gland duct becomes blocked again. If you experience repeated cysts or abscesses, your gynaecologist may recommend procedures such as Word catheter placement or marsupialisation to reduce the risk of recurrence.
Does a Bartholin’s cyst increase the risk of cancer?
A Bartholin’s cyst is usually benign and not cancerous. However, if a new lump develops after the age of 40, or if it feels unusual or persists despite treatment, your doctor may recommend further assessment to rule out other conditions.
Can I still have sex if I have a Bartholin’s cyst?
If the cyst is small and painless, sexual activity may still be possible. However, if it is painful or has developed into an abscess, it is generally advisable to avoid sexual intercourse until it has healed to prevent worsening discomfort and allow recovery.