Bartholin's glands are located between the vagina and the vulva and are usually not visible to the naked eye. They produce a fluid that helps reduce friction during sexual intercourse. However, some women notice a suspicious lump, nothing like a encysted pimple. Learn what a Bartholin's cyst is.
Bartholin's cysts do not always cause pain. Although infectious agents are not responsible for causing the cysts to develop, bacteria can enter the fluid they contain once they have formed. If this occurs, the cysts can become abscesses.
Bartholin's cyst is usually present in about 2% of people who seek gynecologic care. So it is not very common among women.
What is it?
A Bartholin's cyst is a fluid-filled swelling in one of the Bartholin's glands. The glands are on each side of the opening of the vagina, at the lips of the labia. They secrete vaginal lubricating fluid, and this fluid helps protect vaginal tissue during sexual intercourse.
These cysts are not common and usually develop after puberty and before menopause. About 2 percent of women will develop a Bartholin's cyst in their lifetime.
Is it the same as a Bartholin's abscess?
Doctors believe that bacteria, such as E. coli, and sexually transmitted diseases, such as chlamydia or gonorrhea, can cause the infections that can cause a Bartholin's abscess. If bacteria enter the gland, swelling, infection, and blockage can occur.
When fluid builds up in the gland, pressure in the area increases. It can take years for the fluid to accumulate enough to form a cyst, but an abscess can form quickly afterward. If the infection and swelling progresses, the gland may abscess, opening the skin. Bartholin's abscess tends to be very painful. It usually only occurs on one side of the vagina at a time.
The abscess usually causes a lump to form under the skin on one side of the vagina. It will typically cause pain during any activity that puts pressure on the area, such as walking, sitting, or having sex. It is even possible that we have a fever and that the skin is red or swollen.
Reasons for appearance
Bartholin's glands contain small ducts, or openings, that allow fluid to flow through. The main cause of a cyst is the accumulation of fluid that occurs when the ducts become blocked. The ducts can become blocked due to injury or irritation, or additional skin growth.
In some cases, an infection can cause a cyst to grow. Bacteria that can infect a cyst include Escherichia coli and bacteria that cause gonorrhea or chlamydia. Although these cysts can develop at any age, they are most common during the reproductive years, especially between the 20 and 29 years.
The immune system's reaction to a bacterial infectious agent can cause obstruction and subsequent abscess. Examples of these agents include:
- Neisseria gonorrhoeae, which causes gonorrhea, a disease transmitted through sexual contact
- Chlamydia trachomatis, which causes chlamydia
- Escherichia coli, which can affect the water supply and cause hemorrhagic colitis
- Streptococcus pneumoniae, which can cause pneumonia and middle ear infections
- Haemophilus influenzae, which can cause ear infections and respiratory infections
Although doctors do not consider a Bartholin's cyst to be the sole result of sexual transmission, N. gonorrhea is among the most common pathogens doctors isolate when testing for cysts.
Image: Cleveland Clinic
Symptom
Bartholin's cysts can be the size of a pea or as large as a marble. They also tend to grow slowly. Small cysts may not cause any symptoms. Since we can't normally feel the glands, we may not realize there is a small cyst if there are no symptoms.
When symptoms do occur, we typically find:
- Small, painless lump near the opening of the vagina
- Redness near the opening of the vagina
- Vaginal lip bigger than other
- Swelling near the opening of the vagina
- Discomfort during sex, walking, or sitting
If the cyst becomes infected, there may be pus coming out of the cyst, pain, fever, chills, or difficulty walking. An infected cyst is known as an abscess.
Bartholin's cysts should not be a cause for concern in people of reproductive age. However, after menopause, it is prudent to check the genitals for lumps or cysts and consult a doctor about possible malignancies.
Diagnosis
Usually, the doctor can diagnose a Bartholin's cyst after evaluating our medical history and performing a pelvic exam. If the cyst is infected, the doctor may need to take a sample of vaginal discharge to determine if there is a sexually transmitted infection.
If you are over 40 or postmenopausal, a doctor may do a biopsy to look for cancer cells.
Transmission
A Bartholin's cyst may not require treatment if it is small and does not cause any symptoms. If the cyst causes symptoms, we will seek treatment.
Home remedies
If the Bartholin's cyst is small and has no symptoms, treatment may not be necessary. However, it is likely that the doctors will ask us to monitor the cyst and report if it increases in size or is uncomfortable.
Sitting in a warm bath several times a day or applying a warm, wet compress can encourage fluid to drain from the cyst. In many cases, home care may be enough to treat the cyst. Other home treatment options include:
- Analgesics: Taking over-the-counter pain relievers, including acetaminophen and ibuprofen, can help a person with a Bartholin's cyst to ease discomfort.
- a warm compress: Applying gentle pressure to the cyst with a warm water-soaked flannel or cotton washcloth may help.
However, it is important to seek consultation about any unusual or suspicious lumps in the vaginal area, especially if a person has entered menopause.
Surgery
The doctor may use a few different methods to treat a Bartholin's cyst:
- marsupialization: The surgeon cuts the cyst and drains the fluid. They suture the edges of the skin so that secretions can pass through.
- carbon dioxide laser: This highly focused laser can create an opening that helps drain the cyst.
- needle aspiration: The surgeon uses a needle to drain the cyst. Sometimes, after the cyst is drained, they fill the cavity with a 70% alcohol solution for a few minutes before drainage. This solution reduces the risk of bacteria entering the wound.
- Excision of the gland: If a person has many recurring cysts that do not respond well to any therapy, the doctor may recommend complete removal of the Bartholin's gland.
If the cysts keep coming back and other treatment methods don't work, your doctor may surgically remove the gland. This procedure is rare. It cannot prevent a Bartholin's cyst from developing, but it can help prevent complications from developing.
Using a condom or other barrier method during sex and practicing good hygiene can help prevent the cyst from becoming infected.
Prevention
Because doctors aren't sure what caused the initial blockage of the duct, there aren't many recommendations for preventing a Bartholin's cyst.
However, because sexually transmitted diseases, such as gonorrhea and chlamydia, can cause the cyst, sexually active people can reduce their risk by using barrier methods of contraception, such as a condom or dental dam.