You may not be familiar with Bartholin’s glands unless you develop a problem with them. Women have two of these glands, located on each side of the entrance to the vagina. Sometimes they are called greater vestibular glands or vulvovaginal glands.
“The job of this gland is to keep the vulva moist,” said Adedayo Onibokun, MD, a gynecologist with Banner Health. The glands make a fluid that helps lubricate the vulva (external female genitalia) and vagina. Sometimes, a gland can get blocked. When this happens, the fluid builds up and causes a cyst called a Bartholin's cyst.
If you have a small cyst, you might not have any symptoms or even be able to feel it. But a larger cyst can cause discomfort, pain or swelling. “Cysts can also become infected, which is called a Bartholin's abscess,” Dr. Onibokun said.
Sometimes, you can treat a Bartholin's cyst on your own, but other times you may need a medical procedure.
Bartholin's cyst symptoms
“If the accumulated fluid is small, all you will notice is a bump in your vulva,” Dr. Onibokun said. As the cyst gets bigger, you may have:
- Discomfort when you are sitting, walking or having sexual intercourse. The cyst may cause pressure or a feeling of fullness.
- Pain that could feel like a dull ache or a sharp pain and can range from mild to severe.
- Swelling and tenderness. The size of the cyst can vary — it might feel like a small lump or a larger mass.
How you can treat a Bartholin's cyst
You can try warm compresses or sitz baths on your own at home to clear up a Bartholin’s cyst.
They may reduce pain and swelling because the heat helps relax the muscles around the cyst and may help the system drain naturally.
To apply a warm compress, soak a clean cloth in warm water and ring it out. Apply the cloth to the affected area for 15 to 20 minutes. You may need to rewarm the cloth. Repeat this process twice a day.
A sitz bath uses a special basin that fits over the toilet so you can soak the pelvic area in warm water. If you don't have the basin, you can sit in a bathtub filled with a few inches of warm water for 15 to 20 minutes twice a day.
You may want to use over-the-counter (OTC) medications like acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) to manage pain and inflammation.
It's a good idea to keep the area clean to help prevent infection and promote healing. Wash the affected area with mild soap and water, then pat it dry. Avoid scented soaps, sprays or products that could be irritating.
When to get medical care
If the pain, swelling or discomfort isn’t getting better with home remedies or if it's getting worse, it’s important to see a health care provider. “Generally, if you have pain, difficulty walking or redness you should see a gynecologist for treatment,” Dr. Onibokun said.
You’ll want professional care if you have:
- Signs of infection like increased pain, redness, warmth or pus coming out of the cyst.
- A cyst that is growing quickly or becoming unusually large.
- Difficulty with your daily activities.
- A lot of discomfort.
A health care provider can evaluate your symptoms, perform a physical exam and figure out if you have a Bartholin’s cyst or another type of vulva cyst. They can also recommend the right treatment to get your symptoms under control and help prevent complications.
Bartholin's cyst treatment options
“The goal of treatment is to open up the cyst so that the gland can begin draining again,” Dr. Onibokun said. To treat your cyst, your provider may recommend:
Drainage
Drainage removes fluid from the cyst to relieve pressure and pain. It can treat symptoms quickly.
Your provider will use local anesthesia to numb the area, and then use a needle or make a small incision to drain the fluid. But this solution may be temporary. “Usually, just incising the cyst is not enough, as the gland tends to clog up again,” Dr. Onibokun said.
Balloon placement
Placing a tiny balloon in the gland keeps it open. The balloon stays in place for about a month. When it is removed, it leaves a small opening to the gland so the fluid can drain.
“Most emergency doctors do not insert this balloon and only drain the cyst, so there is a high recurrence rate of Bartholin’s cyst. If you can, it is preferred you see your gynecologist for treatment,” Dr. Onibokun said.
Marsupialization
Marsupialization is a surgical procedure. A surgeon makes a small incision in the cyst and stitches the edges to the surrounding tissue. This procedure is done if you have multiple recurrences of your Bartholin’s cyst.
With this permanent opening, the cyst can always drain. It won’t close up and refill with fluid. It can be a good option if you have recurring cysts.
Surgery
Your provider may completely remove the cyst and, in some cases, the gland. Surgery might be an option for cysts that are recurring or not responding well to other treatments or if they might cause complications.
“Marsupialization and surgery are procedures that are done outpatient under anesthesia in an operating room,” Dr. Onibokun said. After treatment, you may have some discomfort, swelling or minor bleeding. Your provider may recommend OTC pain relievers such as acetaminophen or ibuprofen.
Keep the area clean and dry to prevent infection. Your doctor may provide specific instructions, such as using antiseptic wipes or taking sitz baths to promote healing.
“Most Bartholin's cysts and abscesses do not need antibiotics for treatment. As long as it is draining, all the cyst fluid and pus will flush itself out,” Dr. Onibokun said. But you should still contact your provider if you see signs of infection like redness, warmth, swelling or fever.
Be sure to go to all of your follow-up appointments so your provider can check your recovery, make sure the cyst is healing and address any concerns you have.
To reduce the risk of developing future Bartholin's cysts, keep the affected area clean and avoid using harsh or scented products in the vaginal area. Staying hydrated and practicing safe sexual habits can also help.
The bottom line
A Bartholin's cyst can develop when the gland that lubricates your vulva gets blocked and doesn’t drain properly. You may notice discomfort, pain or swelling. You can try treating a Bartholin’s cyst at home with warm compresses or sitz baths.
If these treatments don’t work or your symptoms are concerning or severe, contact your health care provider or an expert at Banner Health.
