Overview
A Bartholin's cyst is a fluid-filled swelling that occurs when the glands located on each side of the vaginal opening (Bartholin's glands) become obstructed, causing fluid to build up within the gland. These glands secrete fluid that helps lubricate the vagina. Bartholin's cysts can range in size from small and painless to larger and painful, especially if they become infected, forming an abscess. They typically occur on one side of the vaginal opening and can be treated with home remedies or surgical drainage, depending on the size and severity of the cyst. Antibiotics may be prescribed if an infection is present.
Understanding the disease
Symptoms
Symptoms of a Bartholin's cyst include a small, painless swelling near the vaginal opening, which may become more noticeable and tender if the cyst grows. If the cyst becomes infected, symptoms may include pain, redness, and swelling in the affected area, as well as a fever. Additional symptoms may include a lump or mass near the vaginal opening that does not improve with self-care methods such as sitz baths. If you experience these symptoms, it is recommended to seek medical attention.
Risk Factors
The risk factors for developing a Bartholin's cyst include:
- Age: Bartholin's cysts are more common in women between the ages of 20 and 40.
- Infection or injury: The cyst may develop due to a blockage in the gland's duct, which may be caused by infection or injury.
- Sexually transmitted infections: A Bartholin's cyst can become infected and form an abscess, with bacteria such as Escherichia coli (E. coli) and those causing sexually transmitted infections like gonorrhea and chlamydia being potential causes.
Development
Bartholin's cysts develop when the openings of the Bartholin's glands become obstructed, causing fluid to back up into the gland. These glands are located on each side of the vaginal opening and secrete fluid that helps lubricate the vagina. When the fluid builds up within the gland, it forms a cyst. The cyst may be non-infected or infected, leading to an abscess if pus forms. Experts believe that the primary cause of Bartholin's cysts is a backup of fluid due to obstruction of the gland's duct. This obstruction may be caused by infection or injury.
Assessment and Diagnosis
Triage
You should see a doctor if you suspect a Bartholin's cyst if you have a painful lump near the opening of your vagina that doesn't improve after two or three days of self-care, such as soaking the area in warm water (sitz bath). If the pain is severe, you should make an appointment with your doctor right away. Additionally, if you find a new lump near your vaginal opening and you're older than 40, you should call your doctor promptly, as this may be a sign of a more serious problem, such as cancer.
Diagnosis
To diagnose a Bartholin's cyst, your doctor may ask questions about your medical history, perform a pelvic exam, and take a sample of secretions from your vagina or cervix to test for a sexually transmitted infection. If cancer is a concern, your doctor may refer you to a gynecologist who specializes in cancers of the female reproductive system. Imaging tests like an X-ray, ultrasound, or MRI may also be used to confirm the diagnosis and rule out other conditions. In some cases, fluid drawn from the cyst with a needle might be used to confirm the diagnosis.
Management and Treatment
Complications
Potential complications of Bartholin's cyst may include:
- Rupture: If a Bartholin's cyst ruptures, it can lead to a boil-like infection that requires prompt treatment.
- Infection: Cysts can become infected, causing pain and inflammation. An abscess may form if the infection is severe.
- Recurrence: A Bartholin's cyst or abscess may recur and require additional treatment. It's important to seek medical attention if you experience severe pain or notice a new lump near your vaginal opening. Early diagnosis and treatment can help prevent complications.
Prevention
on preventing Bartholin's cysts. However, maintaining good hygiene and practicing safer sex may help to prevent infection and the formation of an abscess.
Treatment
Treatment for a Bartholin's cyst depends on the size of the cyst, the level of pain, and whether the cyst is infected. Here are some common treatment options:
- Home treatment: For small, noninfected cysts, home treatment may be sufficient. You can soak the affected area in warm water (sitz bath) for 15 to 20 minutes, three to four times a day to help alleviate discomfort and promote drainage. You can also apply a warm, moist compress to the area to help speed up the healing process.
- Surgical drainage: If a Bartholin's cyst is large, painful, or infected, surgical drainage may be necessary. The doctor may make a small incision to drain the fluid from the cyst, or perform a cystectomy, which involves removing the entire cyst.
- Antibiotics: If the cyst is infected, your doctor may prescribe antibiotics to help treat the infection. It's important to consult a doctor if you experience a painful lump near your vaginal opening that does not improve with home treatment after two or three days, or if you notice a new lump in that area after the age of 40.
Preparing for medical consultation
To prepare for an appointment for a Bartholin's cyst, you should:
- Write down your symptoms, including any that may seem unrelated to the condition.
- List all medications, vitamins, and supplements you are taking along with their dosages.
- Prepare a list of questions to ask your doctor, prioritizing the most important ones. Some basic questions include:
- What's likely causing my symptoms?
- What kind of tests might I need?
- Will the cyst go away on its own, or will I need treatment?
- How long should I wait after treatment before having sex?
- What self-care measures might help relieve my symptoms?
- Will the cyst come back again?
- Do you have any printed material or brochures I can take home with me? What websites do you recommend?
- Make a note of any recent life changes or personal information that may be relevant to your case.
- Be prepared to provide a sample of secretions from your vagina or cervix if your doctor requests it to test for a sexually transmitted infection.
- If you are postmenopausal or over 40 and experiencing a cyst, your doctor may recommend a test of the mass (biopsy) to check for cancerous cells. Remember to bring a notebook or notepad to jot down any important information during your appointment.