Understanding Bartholin Glands and Cysts
A Bartholin cyst develops when one of the Bartholin glands, small structures located on each side of the vaginal opening, becomes blocked.
These glands are not noticeable and produce a small amount of fluid that helps lubricate the vulvar area. The fluid normally drains through ducts onto the surface of the vulva.
When a duct becomes obstructed, the fluid produced by the gland has no pathway to exit and begins to accumulate, causing the gland to swell. This fluid-filled swelling is known as a Bartholin cyst. The size of these cysts can vary, ranging from very small to several centimeters in diameter.
While a Bartholin cyst is a fluid-filled sac, it is distinct from a Bartholin abscess. An abscess forms when the fluid within the cyst becomes infected, leading to a collection of pus. An abscess presents with more severe symptoms and often requires different management than an uninfected cyst.
Causes and the STD Question
The cause of a Bartholin cyst is the blockage of the gland’s duct, which prevents the normal drainage of fluid. This blockage can occur due to reasons such as mucus buildup, inflammation, or irritation of the duct opening. The cyst itself is a mechanical issue related to fluid accumulation, rather than an infectious process.
It is a common misunderstanding that Bartholin cysts are sexually transmitted diseases (STDs). The initial cyst formation is not caused by an STD. However, an existing Bartholin cyst can sometimes become infected by bacteria, leading to a painful abscess.
The bacteria responsible for infecting a Bartholin cyst and forming an abscess are most often common bacteria found on the skin or in the vaginal area, such as Escherichia coli (E. coli) or Staphylococcus aureus. In less common instances, sexually transmitted bacteria, including Neisseria gonorrhoeae (which causes gonorrhea) or Chlamydia trachomatis (which causes chlamydia), can infect a Bartholin cyst. Regardless, the initial cyst formation is not an STD; it is an infection of a pre-existing cyst.
Recognizing Symptoms and Seeking Care
A small Bartholin cyst that is not infected may cause no symptoms and might only be discovered during a routine pelvic examination. When symptoms do occur, they often include a painless lump or swelling on one side of the vaginal opening. This lump does not interfere with daily activities or sexual intercourse.
If the cyst becomes infected and forms an abscess, the symptoms become much more pronounced and painful. Individuals may experience severe pain and tenderness in the affected area, making walking, sitting, or sexual activity uncomfortable. The area around the abscess appears red, swollen, and warm to the touch.
A fever may also develop if the infection is significant. It is advisable to seek medical attention if a painful lump develops near the vaginal opening, especially if it is accompanied by fever or severe pain.
Treatment and Home Management
For small, uninfected Bartholin cysts that cause no symptoms, treatment may not be necessary. These cysts sometimes resolve on their own. Home management strategies can be beneficial for minor cysts or as an initial approach for mild discomfort.
Sitz baths, which involve sitting in a few inches of warm water, can help promote drainage of the cyst and alleviate discomfort. Soaking in a sitz bath regularly can encourage the cyst to drain naturally. Applying warm compresses to the area can also provide benefits.
If a Bartholin cyst is symptomatic, persistent, or has developed into an abscess, medical intervention is required. A common procedure for an abscess is incision and drainage, where a small cut is made to allow the pus to drain. To prevent the incision from closing and the cyst from recurring, a small catheter, such as a Word catheter, may be inserted into the drained cavity for several weeks. For recurrent cysts, a procedure called marsupialization may be performed to create a permanent opening for drainage. Antibiotics may be prescribed if there is evidence of a bacterial infection.