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What’s that lump? Bartholin’s cyst

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Sarah was having a regular, busy Tuesday morning when she hopped in the shower after yoga class.

Sarah lathered up and was mentally making her grocery list when she suddenly realized something was not quite right with her vagina. On closer inspection, she found a lump near its opening. The lump was small and not very tender, but she had never noticed it before.

Her mind immediately started racing: Could it be an infection? Could it be herpes? In that case, my partner has some questions to answer. Could it be cancer?

She called her health care provider for an appointment right away and came to the visit in a panic.

Sarah did the right thing in coming in for evaluation. She might need testing for an infection and certainly an examination for a possible growth or cancer is in order, but the answer could also be much simpler. She could have a cyst in her Bartholin’s glands.

What is a Bartholin’s cyst?

Located on either side of the opening of the vagina, the Bartholin’s glands secrete fluid that helps with lubrication. If one of the glands gets blocked, fluid can back up and create what feels like a lump.

This often painless swelling is called a Bartholin’s cyst. These are scary — but benign. They can, however, become complicated if ignored. If the fluid within the cyst becomes infected, it may develop into an abscess — a collection of pus surrounded by inflamed tissue — that is typically red, painful and warm.

Bartholin’s cysts happen commonly, though they are probably not a common topic of conversation among women. Treatment varies depending on the size of the cyst, how painful it is and whether it’s infected. Sometimes, home treatment is all that’s needed. In other cases, a Bartholin’s cyst has to be surgically drained. If a cyst becomes infected, antibiotics may be needed.

Typical symptoms and self-care

A small, noninfected Bartholin’s cyst may even go unnoticed. If it grows, a lump or mass can be felt near the vaginal opening.

A full-blown infection of a Bartholin’s cyst can develop in a matter of days. Symptoms of that can include:

  • A tender, painful lump near the vaginal opening
  • Discomfort while walking or sitting
  • Pain during intercourse
  • Fever

A Bartholin’s cyst or abscess typically occurs on only one side of the vaginal opening. It may rupture and drain on its own. Taking sitz baths, in which you sit in a tub filled with several inches of warm water and soak several times a day, may help. They’ll also keep the area clean and ease your discomfort. Over-the-counter pain relief medication, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others) may also help.

When to see a health care provider

If the lump near the opening of the vagina doesn’t improve after several days of self-care, it’s time to call your doctor. You should make an appointment right away if the pain is severe.

Also call your doctor promptly if you find a new lump near your vaginal opening and you’re older than 40. Although rare, such a lump may be a sign of a more serious problem, such as a cancer. Similarly, in the case of high-risk exposure (such as a new partner or partner with a new exposure), a health care provider can determine if and what tests and treatments for sexually transmitted infections are needed.

Treatment beyond home care

A Bartholin’s cyst can recur. If that’s the case, the doctor may recommend marsupialization. This procedure involves making a hole in the cyst and possibly placing a catheter in it to drain the gland. Marsupialization is often done in a doctor’s office but may require treatment in the hospital if the abscess is large or deep.

Prevention

There’s no way to prevent a Bartholin’s cyst. However, washing the vagina only with warm water, limiting tight-fitting underwear and clothing, avoiding vaginal perfumes or powders, and safer sex practices may help keep a cyst from becoming infected and an abscess from forming.

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