Bartholin’s Cyst: When the Plumbing’s Backed Up
You’re minding your business one day and notice a lump near your vaginal opening. Cue instant panic. Before your brain jumps to the worst-case scenario, take a breath. You might have what’s called a Bartholin’s cyst—a common and completely treatable reason for a lump “down there.”
What Is It?
The Bartholin’s glands sit on either side of the vaginal opening and help make natural lubrication. Each gland drains through a tiny duct, basically a small opening that lets the fluid out. When that opening gets blocked, fluid builds up and forms a cyst, kind of like a small water balloon under the skin.
Most cysts are harmless and painless, though they can slowly get bigger, feel full or pressurized, or sometimes open up and leak on their own. If bacteria make their way in, the cyst can turn into an abscess, which is when things get painful fast. It can swell, redden, throb, and make even sitting feel impossibly painful.
Why It Happens?
TNo one does anything “wrong” to get a Bartholin’s cyst. Friction, irritation, or a bit of bacteria can block the duct and cause fluid to back up. It’s not related to hygiene or sexual activity, so there’s no blame here. Some people may even have a slight anatomical or genetic tendency that makes blockage more likely, but no one really knows why it happens to some and not others.
What are the Symptoms?
- Sometimes, a lump or swelling on one or both sides of the vaginal opening
- A feeling of pressure or fullness when walking, sitting, or during sex
- Pain, redness, or warmth if it’s infected
- Fever or drainage if it becomes a more severe abscess
- Occasionally, a partner might be the first to notice a lump during intimacy
When to See a Provider
Any new lump in the vulvar area deserves evaluation. Period. You can’t diagnose this yourself, and not all bumps are benign.
You may need more urgent evaluation if the lump is painful, red, enlarging, or draining pus, or if you have a fever or spreading swelling. Those are signs of infection that may need quick treatment. Sometimes that means going to urgent care or even the ER to get it drained and to get pain under control.
Special note: Rarely, a cyst-like bump can be something more serious, like a vulvar cancer. These are extremely uncommon, but they’re more likely to appear in people over 40. If you ever notice a new growth, don’t wait—get it checked out.
In short: if it’s new, growing, or just doesn’t make sense, see a doctor.
Treatment Options
Treatment depends on how big the cyst is, whether it’s infected, and how often it’s come back before.
1. Sitz baths
Soaking in warm water for 10–15 minutes a few times a day can help smaller cysts drain on their own. It’s simple but often works.
2. Incision and drainage
If the cyst is painful or infected, your provider can numb the area and make a small opening to drain it. Relief is usually immediate, but if the new opening closes too soon, the cyst can return—which is why doctors should also place a Word catheter (see below).
3. Word catheter
A Word catheter is a small rubber tube with a tiny balloon at the end. After the cyst is drained, the balloon tip is placed inside to keep the duct open while it heals. It usually stays in for four to six weeks, long enough for a new drainage tract to form and stay open. If it’s removed too soon, the cyst has a higher chance of coming back. Done properly, the recurrence rate is about five to fifteen percent.
4. Marsupialization
For cysts that keep returning, a surgeon can create a small, permanent opening by stitching the edges of the duct to the surrounding skin. Don’t worry—the incisions are done inside the vagina, so there shouldn’t be any visible scarring. It sounds intense, but it’s a straightforward and very effective procedure, usually done under local anesthesia or sedation. Recurrence after marsupialization is only two to ten percent.
5. Gland excision
If cysts just keep coming back, or if there’s any concern for something more serious, the entire Bartholin’s gland can be removed. It’s a longer recovery and permanently removes one of the glands that helps with lubrication, so it’s saved for last-resort cases—but it’s definitive.
The Recurrence Reality
Even after good treatment, Bartholin’s cysts can return. About one in four people get at least one recurrence. The best move is to catch it early. Avoid tight, friction-heavy clothes, and if you ever feel swelling again, have it checked right away.
The Bottom Line
A Bartholin’s cyst can be painful, annoying, and anxiety-inducing—but it’s also one of the most fixable problems out there. Whether it’s a small bump or a full abscess, there are clear, safe treatments that actually work. If something feels off, see a provider. You deserve comfort, not confusion.
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