A Bartholin cyst or abscess can develop in a person who is not sexually active. The Bartholin glands are small structures located on each side of the vaginal opening. They secrete fluid to lubricate the vaginal area and do not depend on sexual activity to operate or become blocked. The formation of a cyst or infection in these glands is not an indication of sexual activity. The condition arises from a physical blockage of the duct, which occurs for many reasons unrelated to sexual transmission.
Understanding the Mechanism of Blockage
A Bartholin cyst forms when the narrow duct leading from the gland to the vulva surface becomes obstructed. When the duct is blocked, the fluid secreted by the gland accumulates, causing the gland to swell into a cyst. Blockage is often caused by inflammation, irritation, or trauma.
The obstruction can also result from infection by common bacteria. A frequent culprit is Escherichia coli (E. coli), which is found in the gastrointestinal tract but can migrate to the vaginal area. This bacterial presence does not require sexual contact to cause blockage.
Thickened mucus or skin debris can also plug the duct opening, leading to fluid retention. While sexually transmitted infections can sometimes cause blockage, the majority of cases are due to non-sexually transmitted factors. The mechanical process of fluid accumulation can happen to anyone with a Bartholin gland, regardless of their sexual history.
Identifying Symptoms and Abscess Formation
A Bartholin cyst is a fluid-filled sac that may range in size from a pea to a golf ball. If the cyst remains small, it often causes no symptoms. If it grows larger, a person may notice a painless lump near the vaginal opening or feel pressure and mild discomfort, especially when sitting or walking.
A Bartholin abscess occurs when the trapped fluid within the cyst becomes infected and fills with pus. An abscess develops rapidly, causing a significant increase in pain and tenderness near the vaginal opening. Signs of infection include noticeable redness and warmth, along with severe, throbbing pain that makes walking or sitting difficult.
A fever may also develop, indicating a spreading infection. If the lump becomes very tender, swollen, and warm, or if a fever is present, an abscess has formed and medical attention is necessary. Recognizing the difference between a small, painless cyst and a rapidly developing, painful abscess helps determine when to seek professional care.
Management and Treatment Options
Treatment for a Bartholin cyst or abscess depends on its size, discomfort level, and whether infection is present. For a small, non-infected cyst that is not causing pain, self-care is often sufficient and may lead to the cyst draining on its own. Self-care involves taking warm Sitz baths several times a day for three to four days to promote drainage and ease discomfort.
If an abscess forms, medical intervention is usually required due to the severe pain. The primary treatment is surgical drainage, often called incision and drainage. A healthcare provider makes a small cut into the lump to allow the pus to drain completely. A small rubber tube, or catheter, may be inserted for several weeks to keep the incision open and ensure full drainage, known as Word catheter placement.
If the cyst or abscess recurs, marsupialization may be performed to prevent future blockages. This involves stitching the edges of the incision open to create a small, permanent pouch, allowing any future fluid to drain freely. Antibiotics may be prescribed if the infection is extensive or if testing reveals a sexually transmitted pathogen, but they are not always needed if the abscess is successfully drained.