Bartholin's cyst: symptoms, treatment and when to get help

The NHS says that if you have been diagnosed with a Bartholin's cyst it will often go away by itself without treatment. Things you can do to help relieve discomfort or pain include sitting in a bath with warm water a few times a day for 3 to 4 days, dipping a cloth or cotton wool in warm water and holding it gently on the cyst, and taking ibuprofen or paracetamol for pain. It says not to try to squeeze or drain the fluid yourself, as this can cause infection.

If you have an infected Bartholin's cyst, the NHS says you will be offered antibiotics. If antibiotics do not work, or the cyst keeps coming back, you may need a surgical procedure to drain it. This may be done under local anaesthetic while you are awake, or under general anaesthetic while you are asleep. The doctor makes a cut in the cyst and may leave a small opening so fluid can drain, or insert a small thin tube (catheter), which is usually left in for around 4 weeks before it is removed.

Patient.info's clinical reference for doctors says that if a cyst is small and not causing a problem no action should be taken, that simple incision often results in recurrence and is not recommended, and that warm baths may encourage spontaneous rupture and relief of symptoms.

The NHS says a Bartholin's cyst happens when small glands in the vagina become blocked, and that it is often not known why the glands become blocked. If a Bartholin's cyst becomes infected, this can cause an abscess.

The NHS says a Bartholin's abscess may be caused by infections, including sexually transmitted infections (STIs) such as gonorrhoea or chlamydia. Patient.info's professional reference says the Bartholin's glands are a pair of pea-sized glands whose secretions maintain moisture at the vaginal opening, and that a blocked duct causes a cyst that may become infected. It says abscesses often involve more than one organism, with Escherichia coli the most common.

The NHS describes a Bartholin's cyst as a lump near the opening of the vagina. They do not always need treatment, but it says to always get any lumps checked by a GP. Bartholin's cysts usually affect women aged between 20 and 50 years.

Patient.info's professional reference says the glands sit at about the 4 o'clock and 8 o'clock positions of the vestibule and normally cannot be felt, that cysts or abscesses are usually on one side, and that cysts occur in about 3% of women, most commonly of childbearing age.

The NHS says the main symptom is a soft lump on 1 side near the opening of the vagina. It can be small and painless and may not cause any symptoms, and can range from the size of a pea to the size of a golf ball. Other symptoms can include discomfort or pain around the vulva when you walk, sit down or have sex, and one side of the vaginal lips looking larger or swollen. It can sometimes be found during routine examinations such as cervical screening.

If the cyst becomes infected and turns into an abscess, the NHS lists smelly discharge from the abscess, feeling unwell or having a high temperature, and intense pain around the abscess.

The NHS says the GP will look at the lump to check if it is a Bartholin's cyst, and you can ask for a chaperone, who could be someone you know, a nurse or a trained member of staff. If the GP is not sure what is causing the lump, they may refer you for further tests. During drainage, the doctor may take some fluid to test for infection.

Patient.info's professional reference says a swab may be taken from the contents of the cyst, and that women over the age of 40 presenting with a Bartholin's cyst or abscess should have a biopsy to rule out carcinoma. It stresses that this is uncommon.

The NHS says that if a cyst keeps coming back you may need a surgical procedure to drain it. Patient.info's professional reference says there is a high rate of recurrence, varying from 0 to 38% depending on the type of surgery used, highest after simple incision and drainage and low after marsupialisation.

If a cyst bursts on its own, the NHS says to keep the area clean and dry to help stop infection. See a GP if the lump returns or keeps recurring.

The NHS says to see a GP if you have a lump in or around your vagina. Get an urgent GP appointment or call 111 if you have a lump and it gets bigger and more painful within hours or days, there is pus in the lump, you feel unwell or have a high temperature, or the lump becomes tender, swollen, hot and red. Redness may be harder to see on black or brown skin. These could be signs of an infected Bartholin's cyst (abscess).

Patient.info's professional reference notes that a new lump in a woman over 40 warrants biopsy to rule out cancer, so it is worth having any new vulval lump checked.

On the NHS, a GP can examine the lump, advise on home care, prescribe antibiotics for infection and refer you for drainage or a catheter procedure if it keeps coming back. The NHS says drainage may be done under local or general anaesthetic.

Some people choose a private gynaecologist for assessment and drainage. Ask which technique is proposed, whether a catheter will be left in and for how long, and how recurrence will be managed.