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By Dr. Richard Honaker | Feb 12, 2019

Bartholin’s Cyst – What to expect?

Our bodies have multiple glands performing different functions. One such gland is the Bartholin’s gland. Every woman has this gland located on each side of the Labia that surrounds the vagina and urethra. The purpose of the gland is to produce small quantities of fluid which lubricates this area.

The fluid exits from small tubes also known as Bartholin ducts. While this is a natural mechanism that continues to happen, sometimes, it is disrupted due to blockage in the Bartholin ducts. This is what leads to the formation of Bartholin’s cyst.

What is Bartholin’s cyst?

When fluid builds up in the gland, due to obstruction in the Bartholin ducts, a cyst is formed. You can think of a Bartholin’s cyst as a cavity filled with liquid or semisolid material that forms under the skin in the vaginal area. The cyst can vary in size, it can be minuscule and barely noticeable or bigger and more visible.

Sometimes, if the fluid in the cyst gets infected, pus can form within the inflamed tissue. This may lead to the area becoming firm and swollen. An infected cyst can be painful and it can make it difficult for a woman to carry out activities such as walking and having intercourse. This pus-filled cyst is also known as an abscess.

What causes it?

Bartholin’s cysts can form due to a number of reasons. They can be the result of an injury, an infection, thicker mucus, or swelling. Any of these things can cause blockage in the ducts leading to the eventual fluid build-up.

Though abscess is usually caused by an infection. While a number of bacteria can lead to the formation of infected Bartholin’s cysts, Sexually transmitted infections (STIs), such as gonorrhea or chlamydia, are the standard culprits. Hence, it is wise to use a condom to lower this risk to developing these cysts.

Can I be affected?

Bartholin cysts occur in about 3% of all women. The highest probability of having a Bartholin’s cyst is during the time a woman is sexually active and is of reproductive age. So most women who report having a cyst are usually in their twenties or thirties. Additionally, another factor is sexual activity. Women who use condoms are less likely to develop Bartholin’s cyst.

Though it is important to note that Bartholin’s cysts usually do not affect younger girls as the Bartholin’s glands don’t start functioning until you reach puberty. Similarly, chances of developing a Bartholin cyst also reduce significantly after menopause.

How do I know if I have a Bartholin’s cyst?

Sometimes the mass is small enough to not even be noticed. However, if the cyst is bigger in size, you may feel a lump or mass near your vaginal opening. The symptoms depend on whether the cyst is infected or not.

How to tell if you have a cyst that’s not infection:

  • The mass is not painful .
  • There is redness or slight swelling near the vaginal opening

How to tell if you have a cyst that’s infected:

  • The mass is painful
  • You experience discomfort walking, moving around or even sitting down
  • Visible swelling and inflammation
  • Fever
  • Drainage from the cyst

When should I consult a doctor?

While Bartholin’s cysts are usually harmless, it is advisable to consult a doctor if you feel a lump or mass near your vagina to confirm if it’s a cyst and rule out any serious medical conditions, particularly, if you’ve hit menopause. A cervical screening test can also be used by your doctor to confirm the diagnosis.

When there is swelling, drainage or fever, it is important to speak to your doctor so that they can use a swab to take a sample of the discharge and identify the bacteria that is causing the infection.

In very few cases, particularly if you’re over 40 years of age, a biopsy may be requested by the doctor, where a small sample of cyst tissue is taken and examined under a microscope to test for a rare kind of cancer called Bartholin’s gland cancer.

Is it true that they can heal naturally?

It may seem surprising but sometimes Bartholin cysts do not require treatment. Is the cyst is painless and no other symptoms are reported, medical professionals advise to let it heal naturally without any intervention.

If there is pain or swelling, for smaller cysts which are not infected, over-the-counter pain relief medications such as ibuprofen can be taken. In addition to this, it is important to keep the area clean, take warm baths and avoid sexual activity until the skin has healed.

Even when the cyst is infected, it may break open and start healing itself. However, if this does not happen or you are experiencing the symptoms listed above, medical intervention is required.

How is it treated?

There are different types of treatments available depending on the type of Bartholin’s cyst, the degree of infection, and level of pain you’re experiencing. One of the most common treatment options is prescribing antibiotics. The antibiotics help fight the infection and reduce the inflammation.

Other methods include inserting a word catheter and inflating it. Your doctor may leave the catheter for 2 to 4 weeks, to help drain the fluid. Instead of a catheter, sometimes a needle can also be used to drain the cyst. Sometimes, after the cyst has been drained, the cavity is cleaned with a 70 percent alcohol liquid solution to prevent future infections.

Sometimes a carbon dioxide laser can be used both to vaporize and remove the Bartholin gland. While this surgical procedure is considered effective, takes less time and is quite simple, it is also expensive.

You can also consider marsupialization. In this surgical process, the surgeon makes a small incision in the cyst and places a few stitches on either side of the incision. This helps in draining the fluid from the cyst out of this small, permanent opening.

If you experience recurring cysts and conventional therapies aren’t working, your doctor may advise you to consider gland excision. This is when the Bartholin gland and duct are surgically removed. Though, this process is only recommended if other options are ineffective.

Are there any prevention tips?

While there is no specific way to prevent Bartholin’s cysts from forming, there are a few precautions you can take.

When having sexual intercourse, it is advisable to indulge in safe sex practices, particularly using condoms, not only to prevent STIs but also the likelihood to developing cysts. Secondly, good hygiene habits can help prevent infections in case you do develop a cyst.

If you’d like to know more about Bartholin’s cysts or would like to get medical advice from a doctor, feel free to reach out to one of our doctors or read our related blogs.

Frequently Asked Questions About Bartholin’s Cysts

How common are Bartholin cysts?

Bartholin’s cysts are more common that you think. According to research, one in every 50 women develops a cyst or abscess. Though, the chances of getting a Bartholin’s cyst are higher if you are sexually active and are in your twenties or thirties. Younger girls are usually not affected because the Bartholin’s glands only start functioning after puberty.

Is Bartholin’s cyst caused by stress?

Bartholin’s cysts form when the Bartholin ducts, small openings which enable the fluid produced by the Bartholin’s glands to be released, get blocked. As the exact reason for this blockage is unknown, we can not link the formation of Bartholin’s cysts to stress.

Can I use castor oil for bartholin cyst?

There are a few natural remedies that many women swear by. One of these is castor oil. While castor oil is known for aiding healing process and reducing inflammation in general, we recommend consulting with a doctor first.

It’s always important to consult your physician, particularly if you have a Bartholin’s abscess, to rule out any underlying problems. Your physician can then provide you better advice based on the size and condition of the cyst.

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