What are Bartholin's Cysts? Symptoms, Causes, Photos, and Treatment

What is a Bartholin's Cyst?

A Bartholin's cyst (also called a Bartholin's duct cyst) is a fluid-filled lump that can develop in one of the Bartholin's glands located on either side of the vaginal opening. These small glands produce a lubricating fluid that helps keep the vagina moist. When one of the ducts of these glands becomes blocked, it can lead to a cyst forming.

Bartholin's cysts are usually painless and do not cause any symptoms initially. As they grow larger, they may cause discomfort, pain, and interference with walking, sitting, or sexual intercourse. Bartholin's cysts are very common, affecting about 2% of women at some point in their lifetime.

Symptoms of a Bartholin's Cyst

Some common signs and symptoms of a Bartholin's cyst include:

• A painless lump or bump on one side of the vaginal opening
• Tenderness, discomfort, or pain in the area of the lump
• Swelling that causes asymmetry of the labia
• Redness or warmth over the area of the cyst
• Fever or discharge coming from the cyst (signs of infection)
• Difficulty walking, sitting, or having intercourse
• General discomfort in the vulvar area

Causes and Risk Factors

There are a few potential causes and risk factors for developing a Bartholin's cyst:

• Blockage of the Bartholin's duct - This prevents fluid from draining properly and allows it to accumulate and form a cyst.
• Bacterial infection - Bacteria can enter and infect the blocked Bartholin's duct.
• Prior trauma or irritation - Injury or inflammation in the area of the Bartholin's gland.
• Use of irritating products - Things like douches, lubricants, scented pads or tampons.
• Cancer - Very rarely, a Bartholin's cyst could be caused by vulvar cancer.
• Pregnancy - Increased hormone levels and changes in the vaginal area can lead to cysts.

Diagnosing Bartholin's Cysts

Bartholin's cysts are usually diagnosed based on a physical exam of the vulvar area by a doctor. Your doctor will look for a lump or mass near the vaginal opening and may check for tenderness and fluid buildup. They may also take a sample of any discharge from the cyst to check for infection.

Imaging tests like ultrasound or CT scan are not usually needed to diagnose a Bartholin's cyst. However, they may be used if the doctor cannot determine the cause of the lump based on a physical exam alone.

If the cyst is infected, your doctor may take a sample of the fluid to identify the type of bacteria causing the infection.

Differential Diagnoses

Some other conditions that can cause similar symptoms and may need to be ruled out include:

• Abscess - a pus-filled mass often due to a bacterial infection
• Cellulitis - a bacterial skin infection that causes redness and swelling
• Vulvar cancer - rare cancer of the external female genitalia
• Inclusion cyst - cysts that can develop after female genital surgery
• Hidradenitis suppurativa - chronic skin condition causing abscesses and scarring

Treating Bartholin's Cysts

Treatment depends on the size of the cyst, level of discomfort, and whether it is infected. Options may include:

Drainage

A minor surgical procedure can be done in your doctor's office to drain the fluid from the cyst. This may provide relief but often the cyst comes back unless the cyst sac is also removed.

Marsupialization

This minor surgery opens up the cyst and sutures part of the cyst wall to the skin surface. This creates a permanent opening to allow ongoing drainage and prevent fluid buildup.

Excision

Surgical removal of the entire cyst is the most effective treatment to prevent recurrence. This is usually done for very large or recurrent cysts. General or local anesthesia is used.

Catheter Placement

A word catheter may be placed for 4-6 weeks to allow continuous drainage of the cyst. This helps shrink the cyst over time.

Antibiotics

Oral or topical antibiotics may be prescribed if the cyst is infected to clear up the infection.

Sitz Baths

Sitting in warm water can help soothe pain and discomfort associated with a Bartholin's cyst. Adding epsom salts may provide further relief.

Pain Medication

Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain. Prescription medication may be given for severe pain.

Cyst Aspiration

A needle and syringe can be used to aspirate or drain fluid from the cyst without excising it. This may reduce size but often cysts fill back up.

Home Treatment and Prevention

You may be able to help prevent Bartholin's cysts from recurring or worsening with some self-care measures:

• Use warm compresses on the area to help promote drainage.
• Avoid potential irritants like scented pads, tampons, creams, etc.
• Keep the area clean but do not use harsh soaps.
• Wear cotton underwear and avoid tight clothing.
• Apply a cool compress to relieve swelling.
• Get checked for STIs if sexually active.
• See your doctor if you have any lumps, pain, or worrisome symptoms.

When to See a Doctor

You should see your doctor or gynecologist if:

• You notice a new vulvar lump or mass.
• A cyst becomes increasingly painful or swollen.
• You have fever, chills, or redness around the cyst.
• Symptoms interfere with walking or sexual intercourse.
• The cyst does not improve with home treatment.
• You have concerns about cancer or other serious causes.

Complications of Bartholin's Cysts

Most Bartholin's cysts do not lead to major complications. However, some potential problems can develop, including:

Infection

Bacteria entering a blocked duct can cause an infected Bartholin's cyst or abscess. Signs include fever, increasing pain, redness, and pus draining from the cyst.

Recurrence

Cysts often come back after simple drainage unless the cyst wall is fully removed. Marsupialization helps lower the risk of fluid buildup recurring.

Adhesions

Scar tissue can form after surgery and cause the labia to stick together. Gentle massage of the area may help prevent this.

Dyspareunia

Painful sexual intercourse can occur if a cyst interferes with the opening of the vagina.

When to Seek Emergency Care

You should seek prompt medical care if you experience:

• Sudden, severe vulvar pain
• Fever over 101F (38.3C)
• Signs of a cyst abscess - intense pain, redness, heat
• Inability to urinate due to large, obstructing cyst
• Excessive bleeding from a ruptured cyst

Severe infection that is not treated quickly can lead to sepsis, so urgent medical treatment is needed.

Photos of Bartholin's Cysts

Here are some photos of Bartholin's cysts to help identify their typical appearance:

Small Bartholin's Cyst

A small, rounded Bartholin's cyst on the labia minora near the vaginal opening. The overlying skin appears normal.

Infected Bartholin's Cyst

An infected cyst appears as a tender, red lump with swelling and overlying skin redness. Pus may drain from an opening in the cyst.

Large Bartholin's Cyst

A large Bartholin's cyst can bulge outward and make the labia appear asymmetric. This can cause significant discomfort.

Drained Bartholin's Cyst

After drainage, a Word catheter is often left in a Bartholin's cyst to help prevent fluid accumulation. The overlying skin may appear bruised.

Takeaways

• Bartholin's cysts are fluid-filled lumps that form when a gland near the vaginal opening gets blocked.
• They often don't cause symptoms but can become painful if infected or very large.
• See your doctor if you notice a vulvar lump, pain, or other concerning symptoms.
• Treatment options include drainage, marsupialization, cyst removal, and antibiotics for infection.
• Proper hygiene and avoiding irritants may help prevent recurrence of cysts.
• Call your doctor promptly if a cyst becomes severely painful or infected.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.