Bartholin’s Cyst – Treatment
A Bartholin’s cyst (bartolinitis) is a small sac of fluid that can develop on the glands located on each side of the vagina, known as the Bartholin’s glands. The Bartholin’s glands secrete fluid to help lubricate the vagina during sexual intercourse. Occasionally, the opening of these glands will become obstructed, causing a fluid build-up that results in a relatively painless swelling of the area. A Bartholin’s cyst is often the size of a pea and can sometimes become as large as a marble. This type of cyst can affect either side of the vaginal opening, but typically only one side at a time.
Bartholin’s cysts don’t always cause pain, and more often than not, the person affected doesn’t even realize it’s there in the first place. Some might notice a small, firm lump on the outside of the vagina that can be tender to the touch, but otherwise, the cyst does not cause any noticeable symptoms. Rarely, a Bartholin’s cyst will become infected, forming a painful, pus-filled abscess. If you are experiencing pain or have any concerns about the affected area, it’s always best to reach out to your doctor for further treatment.
To prevent Bartholin’s cysts from becoming infected and progressing to an abscess, it’s important to practice safe sex by using forms of protection, such as condoms, that act as a barrier against sexually transmitted infections. Practicing good hygiene can also prevent a cyst from becoming infected and requiring medical attention.
Key symptoms of a Bartholin’s cyst:
- A small, often painless, lump near the vaginal opening
- Increased redness, irritation, or swelling near the vaginal opening
- Discomfort in the affected area while walking, sitting, or during sexual intercourse
If the cyst becomes infected (known as a Bartholin’s abscess), additional symptoms may include:
- Pus draining from the cyst
- Increased pain
- Fever or chills
- Difficulty walking, sitting, or moving around, or pain during sexual intercourse
- Increased inflammation and tenderness around the vaginal opening
- Treatment for a Bartholin’s cyst or abscess
A sitz bath is a very popular and inexpensive bartholin cyst home treatment. A sitz bath can be purchased online or from your local pharmacy, but all you need is a bathtub and access to warm water. To make a sitz bath, fill your bathtub with enough warm water to cover your vulva, approximately 2-3 inches. A sitz bath is most effective when only the irritated area is submerged in water because the warm water will jumpstart your body’s healing response by increasing blood flow to the area. You can also add ½ to 1 tablespoon of baking soda, or 1 to 2 teaspoons of salt to the water to help inhibit bacterial growth and reduce the risk of infection. For best results, soak in a sitz bath a couple continually for 10-15 minutes a day to encourage the cyst to break and deplete by itself. In the meantime, you can take an over-the-counter pain reliever, such as acetaminophen (Tylenol), to help with any discomfort or pain.
If the cyst does not go away after multiple days of self-care, it might be necessary to seek professional treatment. A visit with your doctor may include:
- A full pelvic exam
- Testing of the vagina and/or cervix for any sexually transmitted infection
- A biopsy of the cyst, if you are over 40 or postmenopausal, to test for cancerous cells
Once the Bartholin’s cyst is determined, your doctor will recommend a treatment moving forward.
If the cyst has become infected and painful, your doctor will most likely prescribe antibiotics for cysts, which can kill the bacteria that caused the infection. This may be a good option if the infection is a result of a sexually transmitted infection. Antibiotics may also be necessary if the infection spreads to the surrounding skin and genital area.
Although the bartholin cyst removal is uncommon, your doctor may recommend it to prevent any further complications to the area. If the cyst is large and symptomatic, your doctor can make a small cut to the area to allow the fluid to drain. This procedure isn’t invasive and can be done in the office using a local anesthetic.
If the cyst is recurring, your doctor can insert a small tube into the cyst and leave it in place temporarily to encourage the cyst to drain and prevent the glands from becoming blocked. Once the cyst is drained, you may see immediate relief. However, pain from the incision can last a few days. Speak to your doctor about the best pain management methods.
Your doctor can also perform a surgical procedure called Marsupialization. This form of surgery involves making a small incision in the cyst and suturing the edges of the slit to create what appears to be a small “kangaroo pouch,” which will allow any excess fluid to drain freely. This process is brief, typically only 30 minutes to an hour, and you will be able to go home the same day.
In the incredibly rare instance that the cysts become chronic and untreatable, the Bartholin’s glands can also be surgically removed. This surgery is the most invasive of all methods and will require general anesthesia. Possible complications can include excessive bleeding, bruising, and infection. This method is often recommended for postmenopausal women, because of the increased risk of vulvar cancer.
Frequently Asked Questions:
Are Bartholin Cysts Dangerous?
Bartholin’s cysts are more common for women in their 20s and typically aren’t cause for concern. If you are over the age of 40 or postmenopausal and develop a cyst, you should immediately contact your doctor. It may be necessary to do a biopsy of the cyst to ensure the cells aren’t cancerous.
Do Bartholin Cysts Go Away On Their Own?
Typically, Bartholin’s cysts will go away on their own, but you can do a series of sitz baths or use heat compress on the affected area to encourage healing and drainage of the cyst.
How Long Does It Take for A Bartholin Cyst To Go Away?
If the cyst does not go away within a few days of home treatment, you should contact your doctor for further instruction. It’s especially important to contact your doctor if you develop a fever or chills. Symptomatic and infected cysts can take a few weeks to fully heal.
Can I have Sex When I Have The Bartholin Cyst?
If you have a cyst that is painful or symptomatic, it’s best to refrain from sexual activity until the area is healed to prevent further infection and symptoms.
Can The Bartholin Cyst Come Back?
Though rare, a Bartholin’s cyst can become recurring, especially if the cyst is caused by an STI or another form of bacteria. Contact your doctor to talk about surgical methods if this type of cyst becomes chronic. It’s also important to practice safe sex by using a condom, or another barrier method form of protection, and to practice good hygiene regularly.
If you have concerns about any abnormalities that appear in the areas surrounding your genitals, it is always a good idea to contact a healthcare professional to receive the best advice moving forward. Although Bartholin’s cysts are typically benign and asymptomatic, it’s important to rule out any conditions that may be more high-risk.
Dr. David Ellman is a board certified OB/GYN that will provide expert medical experience for your needs. Visit our website to learn more about Dr. Ellman and the service he provides.