Summary about Disease
A Bartholin's cyst is a fluid-filled sac that develops when a Bartholin's gland, located on each side of the vaginal opening, becomes blocked. These glands normally secrete a lubricating fluid. When a duct is obstructed, mucus backs up, causing swelling and cyst formation. Small cysts are often painless, but larger ones can cause discomfort and pain, especially when sitting, walking, or during sexual activity. In some cases, the cyst can become infected, forming an abscess.
Symptoms
A painless or painful lump near the vaginal opening.
Redness, swelling, and tenderness in the vulvar area if infected.
Pain with walking, sitting, or sexual intercourse.
Fever (if an abscess forms).
Drainage of pus from the cyst if it ruptures.
Causes
The exact cause of a Bartholin's cyst is often unknown. However, potential causes include:
Blockage of the Bartholin's gland duct, preventing the gland from secreting fluid.
Infection, often by bacteria like Escherichia coli (E. coli), or sexually transmitted infections (STIs) like gonorrhea or chlamydia.
Thickened mucus.
Injury to the area.
Medicine Used
Pain relievers: Over-the-counter pain medications like ibuprofen or acetaminophen can help manage discomfort.
Antibiotics: Prescribed if the cyst is infected and an abscess has formed. Common antibiotics include cephalexin, doxycycline, or azithromycin. The specific antibiotic will depend on the suspected bacteria.
Sitz baths: Soaking in warm water several times a day can promote drainage and healing.
Surgical Drainage/Marsupialization: A small incision is made to drain the cyst, and the edges are sutured to the surrounding tissue to create a permanent opening for drainage.
Word Catheter Insertion: a small balloon catheter is inserted into the cyst to maintain drainage for several weeks.
Bartholin's Gland Excision: In rare cases, the gland may be surgically removed if other treatments are ineffective.
Is Communicable
A Bartholin's cyst itself is not communicable. However, if the cyst is caused by a sexually transmitted infection (STI), that STI is communicable.
Precautions
Practice good hygiene by washing the vulvar area regularly with mild soap and water.
Practice safe sex to reduce the risk of STIs.
Avoid tight-fitting clothing that can irritate the area.
If you notice a lump or discomfort in the vulvar area, see a doctor promptly.
How long does an outbreak last?
Without treatment, a small, uninfected Bartholin's cyst may persist indefinitely or resolve on its own. An infected cyst (abscess) will continue to worsen without treatment, causing increasing pain and potentially spreading infection. With appropriate treatment (antibiotics, drainage), the infection typically resolves within a week or two. The healing process after drainage or marsupialization can take several weeks.
How is it diagnosed?
Physical exam: A doctor can usually diagnose a Bartholin's cyst by examining the vulvar area.
Pelvic exam: To rule out other possible causes of symptoms.
STI testing: If an STI is suspected, tests for gonorrhea, chlamydia, or other infections may be performed.
Biopsy: If the cyst is solid, fixed, or suspicious, a biopsy may be taken to rule out cancer (especially in women over 40).
Timeline of Symptoms
Initial stage: A small, painless lump may be noticed near the vaginal opening.
Progression (if untreated): The lump may gradually increase in size, causing discomfort or pain, especially when sitting or walking.
Infection (if it occurs): Redness, swelling, tenderness, and throbbing pain develop rapidly. Fever may also occur.
Rupture (if it occurs): The cyst may rupture spontaneously, releasing pus and relieving some of the pressure and pain.
Post-treatment: Pain and inflammation gradually subside with antibiotics and/or drainage.
Important Considerations
Self-treating a suspected Bartholin's cyst with antibiotics without a doctor's evaluation is not recommended.
Recurrence is possible, even after treatment.
Persistent or recurrent cysts may require more definitive treatment, such as marsupialization or gland excision.
It is important to seek medical attention to rule out other potential causes of vulvar lumps or pain, particularly in women over 40, where the risk of cancer is slightly higher.