Bartholin’s Cyst and Abscess: Causes, Symptoms and Treatment

Have you noticed a lump near the opening of your vagina? Here’s what every woman should know.

Discovering a lump around your private area can be worrying, especially if it becomes painful or uncomfortable when walking, sitting or having sex. One possible cause is a Bartholin’s cyst.

The good news is that Bartholin’s cysts are usually harmless, and effective treatments are available.

In this article, we explain what Bartholin’s cysts are, why they develop, how to recognise an infection, and when to seek medical attention.

What is a Bartholin’s cyst?

Every woman has two small glands called Bartholin’s glands, located on either side of the vaginal opening.

These glands produce a small amount of fluid that helps keep the area around the vaginal opening moist and lubricated.

Normally, this fluid passes through tiny tubes (ducts) onto the surrounding skin.

Sometimes, one of these tubes becomes blocked. When this happens, fluid collects inside, causing a swelling known as a Bartholin’s cyst.

A cyst may remain small and painless, meaning you might not even notice it.

However, if the cyst becomes infected and fills with pus, it is called a Bartholin’s abscess.

An abscess is usually much more painful and may require medical treatment.

How common are Bartholin’s cysts?

Bartholin’s cysts and abscesses affect approximately 2 in every 100 women.

They are more commonly seen in sexually active women under the age of 40, although they can occur at other ages.

What causes a Bartholin’s cyst?

The main cause is blockage of the tiny tube that allows fluid to drain from the Bartholin’s gland.

This blockage may occur because of:

Swelling or inflammation around the gland.
Infection.
Injury or irritation to the surrounding tissues.
Previous surgery or trauma involving the vulva (the external female genital area).

Sometimes, there is no obvious reason why the blockage develops.

Is a Bartholin’s cyst a sexually transmitted infection (STI)?

No. Having a Bartholin’s cyst does not automatically mean you have an STI.

An abscess can develop when ordinary bacteria that live on the skin or in the surrounding area cause an infection.

However, sexually transmitted infections, including gonorrhoea, may occasionally be involved.

Your healthcare professional may recommend STI testing if appropriate.

What are the symptoms?

Symptoms depend on whether the swelling is a simple cyst or an infected abscess.

Signs of a Bartholin’s cyst

You may notice:

A soft lump on one side of the vaginal opening.
Mild discomfort when sitting or walking.
A feeling of pressure around the vaginal opening.
Discomfort during sexual intercourse.

Small cysts may cause no symptoms at all.

Signs of a Bartholin’s abscess

If the cyst becomes infected, symptoms may include:

A painful, swollen lump near the vaginal opening.
Redness and tenderness around the swelling.
Pain when sitting, walking or having sex.
Increasing swelling over time.
Fever or feeling generally unwell in some cases.

An abscess may develop rapidly and can become extremely painful.

Important: Not every lump around the vagina is a Bartholin’s cyst. Other skin cysts and swellings can look similar, so it is important to have a new or persistent lump assessed.

How is a Bartholin’s cyst diagnosed?

In most cases, a doctor or other qualified healthcare professional can diagnose a Bartholin’s cyst by asking about your symptoms and examining the affected area.

They may check:

The size and position of the swelling.
Whether the lump is painful.
Signs of infection.
Whether you have experienced similar swellings before.

If an abscess is drained, a sample of the fluid may be sent to a laboratory to identify the bacteria causing the infection.

Additional tests may be recommended if the lump has unusual features.

How are Bartholin’s cysts treated?

Treatment depends on the size of the cyst, how uncomfortable it is, whether infection is present, and whether the problem has happened before.

Not every Bartholin’s cyst requires an operation.

1. Simple treatments at home

For a small cyst causing little discomfort, simple measures may help.

These include:

Warm sitz baths: Sitting in a shallow bath of comfortably warm water may soothe the affected area.

Warm compresses: Applying a clean, warm compress can help relieve discomfort.

Pain relief: Paracetamol or ibuprofen may help, provided they are safe for you to take.

Gentle hygiene: Keep the area clean and avoid harsh soaps or products that may cause irritation.

Do not squeeze, puncture or attempt to drain the cyst yourself, as this may cause injury or worsen an infection.

If symptoms do not improve, medical treatment may be needed.

2. Antibiotics

Antibiotics are not always necessary for a Bartholin’s cyst or abscess.

They may be recommended if:

You have a fever or feel unwell.
Infection is spreading into the surrounding skin.
A sexually transmitted infection is suspected.

An abscess containing pus may still need to be drained, even when antibiotics are prescribed.

3. Word catheter treatment

A Word catheter is one of the commonly used treatments for a painful or infected Bartholin’s cyst.

It is a small, soft tube with a tiny balloon at one end.

The procedure usually involves:

Numbing the area using a local anaesthetic.
Making a small opening in the cyst to drain the trapped fluid or pus.
Placing the small tube inside the opening.
Inflating the balloon gently so the tube stays in place.

The catheter allows fluid to continue draining while a new drainage passage forms.

How long does it stay in place?

Usually around 4–6 weeks. A follow-up appointment is arranged to check healing and remove the catheter.

What are the benefits?

Often performed without a general anaesthetic.
Usually does not require an overnight hospital stay.
Allows relatively quick recovery.
Has a low risk of the cyst returning.

The catheter may occasionally fall out earlier than planned or cause discomfort. If this happens, contact your treating clinic for advice.

4. Marsupialisation: a small surgical procedure

If a cyst or abscess keeps coming back, your doctor may recommend an operation called marsupialisation.

During this procedure, the cyst is opened and drained. The edges of the opening are then stitched to the surrounding tissue to create a small permanent drainage opening.

This helps stop fluid building up again.

Marsupialisation is generally performed under general anaesthesia or another suitable form of anaesthesia.

It may be recommended when:

The cyst repeatedly returns.
A Word catheter has not been successful.
The catheter procedure is unsuitable or cannot be tolerated.

Possible complications include bleeding, infection, scarring and the cyst returning.

5. Removal of the Bartholin’s gland

In uncommon cases, particularly when cysts continue to return despite treatment, surgery to remove the gland may be considered.

This is a more extensive procedure with a greater risk of bleeding and other complications.

It is therefore usually reserved for selected patients.

Can a Bartholin’s cyst come back after treatment?

Yes. Even after successful treatment, a cyst or abscess can occasionally return.

Research involving 160 women compared Word catheter treatment with marsupialisation.

The study found that, within one year:

12 in 100 women treated with a Word catheter experienced a recurrence.
10 in 100 women treated with marsupialisation experienced a recurrence.

This means both treatments were similarly effective at preventing the problem from returning.

The Word catheter also offers the advantage of being a simpler outpatient procedure for many women.

How long does recovery take?

Recovery varies depending on the treatment.

Following Word catheter insertion, many women can return to their usual activities relatively quickly, depending on their comfort.

The catheter generally stays in place for several weeks to allow healing.

Recovery after marsupialisation may take longer because it involves a surgical wound.

Tips for recovery

After treatment:

Keep the area clean and gently dry.
Wear loose, comfortable underwear and clothing.
Use sanitary pads if there is some discharge.
Take recommended pain relief when necessary.
Follow the advice from your healthcare team about sexual activity.
Attend any planned follow-up appointment.

Seek medical advice if you develop increasing pain, heavy bleeding, fever or worsening swelling.

Can a Bartholin’s cyst be cancerous?

Most Bartholin’s cysts are not cancerous.

Cancer arising from a Bartholin’s gland is very rare.

However, a new lump in the Bartholin’s gland area, particularly in a woman aged 40 or older, should be assessed carefully.

A healthcare professional may recommend a biopsy, which involves taking a small sample of tissue for examination.

Features that require assessment include:

A hard or unusually firm lump.
A lump that appears fixed to surrounding tissues.
An irregularly shaped swelling.
A lump that persists or continues to grow.

These features do not necessarily mean cancer is present, but they should not be ignored.

When should you see a doctor?

Arrange a medical appointment if you notice a new lump near your vaginal opening, particularly if it persists, becomes uncomfortable or returns after treatment.

Seek urgent medical assessment if the swelling becomes severely painful, grows rapidly, is accompanied by fever, or makes walking or sitting very difficult.

If you feel seriously unwell, seek urgent care.

Frequently asked questions

Can a Bartholin’s cyst disappear without treatment?

Yes. Small cysts may settle on their own, particularly when they are not infected or causing symptoms.

Can I have sex if I have a Bartholin’s cyst?

A small, painless cyst may not affect sexual activity. However, sex may be uncomfortable if the cyst is swollen or infected. After a procedure, follow your healthcare professional’s advice about when to resume intercourse.

Can a Bartholin’s cyst affect my fertility?

A Bartholin’s cyst does not usually affect the ovaries, womb or ability to become pregnant.

Is a Bartholin’s cyst caused by poor hygiene?

No. Cysts develop when a gland’s drainage duct becomes blocked. Having one does not mean that you have poor personal hygiene.

Will I always need surgery?

No. Many small cysts require little or no treatment. Procedures are usually considered for painful, persistent, infected or recurrent swellings.

Final thoughts On Bartholin’s Cyst Causes, Symptoms and Treatment

A Bartholin’s cyst can be uncomfortable and sometimes frightening, especially when it causes sudden pain and swelling around the vaginal opening.

However, it is a common and usually treatable condition.

Small cysts may improve without invasive treatment, while painful abscesses often benefit from drainage using a Word catheter or another appropriate procedure.

The most important thing is not to ignore a new, painful or persistent lump.

Early medical assessment can help identify the cause, relieve symptoms and ensure you receive the right treatment.

Remember: A lump near your vagina is not always something serious, but it deserves attention if it is new, painful, persistent or changing.

Medical reference

Bati-Paracha A, Sharma M. Management of Bartholin’s cyst and abscess. The Obstetrician & Gynaecologist. 2023;25:72–77.

https://doi.org/10.1111/tog.12847

This article is based on a professional educational review published in The Obstetrician & Gynaecologist. It is provided for general health education and does not replace personalised advice from a qualified healthcare professional.