Bartholin's cyst: why it develops, how it feels and what you can do

You'd just stepped out of the shower or been to the loo, felt a swelling next to the vaginal opening, and your stomach instantly dropped? The first thing most people feel when they discover a Bartholin's cyst – which is what this little lump beside the vaginal opening is called – isn't pain. It's fear.

But here too, when it comes to your intimate health: there's no need to panic. A Bartholin's cyst is a benign change and the most common cystic lesion of the vulva. It affects around 2% of women at some point in their lives, most often between the ages of 20 and 50, when one of the Bartholin's glands becomes blocked and the fluid can no longer drain normally. The result is a swelling – sometimes small and painless, sometimes inflamed and extremely uncomfortable.

In this article you'll learn what symptoms such a cyst can cause, when you should see a gynaecologist, and what medical treatment involves.

Here's what you'll find on this page:

• A Bartholin's cyst is benign and the most common cystic change of the vulva.
• Many small cysts cause no symptoms and can resolve on their own without treatment.
• Sitz baths can help – but never try to squeeze or pierce the cyst at home.
• Any new swelling should be checked by a doctor, particularly if you're over 40.

Want to jump straight to the information you need? Choose the section you'd like to read below:

1. What a Bartholin's cyst is and where the Bartholin's glands actually are
2. Why a Bartholin's cyst develops: causes and risk factors
3. What a Bartholin's cyst feels like and how it looks
4. What you can do at home for a Bartholin's cyst (and what you should never do)
5. When to see a doctor and when it's an emergency
6. How the diagnosis is made
7. Medical treatment of a Bartholin's cyst
8. What happens if the Bartholin's cyst bursts on its own
9. Does a Bartholin's cyst come back?
10. Bartholin's cyst in pregnancy
11. Everyday life with a Bartholin's cyst
12. Can a Bartholin's cyst be prevented?
13. Frequently asked questions

What a Bartholin's cyst is and where the Bartholin's glands actually are

To understand what a Bartholin's cyst is and how it forms, let's first look at the Bartholin's glands and what they do. So let's start at the beginning: where are they and what's their job?

The Bartholin's glands are two paired, very small glands. Each measures about 0.5 cm – roughly the size of a pea – and they sit in the area of the vaginal vestibule, around the vaginal opening. If you picture this area as a clock face, they're located at roughly 4 and 8 o'clock, about 1 cm beneath the skin.

Although they're small, the Bartholin's glands have an important function. They produce the fluid that moistens the vulva and vagina, especially during sexual arousal. This fluid reaches the surface via a narrow duct.

In healthy patients, the two Bartholin's glands can't be felt. A problem only arises when this duct becomes blocked. The fluid can no longer drain, builds up inside and gradually forms what we call a Bartholin's cyst.

In other words, the cyst isn't an enlarged gland but a collection of fluid that forms when the drainage duct is blocked.

As a rule, the cyst appears on one side only, and its size can vary considerably. Some are so small you barely notice them, while others reach 2–4 cm, sometimes even up to 5 cm. To put that in perspective: the size can range from a pea to a golf ball.

Why a Bartholin's cyst develops: causes and risk factors

A Bartholin's cyst forms when the gland's duct becomes blocked and the secretion it produces collects in a small cavity. Harvard Health links blockage of the Bartholin's gland to various causes, such as infections, inflammation or long-standing irritation. In practice, however, we don't know exactly what blocks the gland. What has been identified, though, are several factors associated with bartholinitis, including:

• Irritation or injury to the vulva, for example after a vaginal birth or an episiotomy
• Common bacterial infections, such as E. coli
• Sexually transmitted infections such as gonorrhoea or chlamydia, which play a role mainly in abscesses.

But be aware: although infections can be involved in the development of a Bartholin's cyst, and an abscess occurs more frequently in women at increased risk of sexually transmitted infections, the cyst itself is not a sexually transmitted infection. It isn't contagious and therefore isn't passed on through skin-to-skin contact.

And aside from these factors, there's one thing that is not a cause of bartholinitis: hygiene. The cyst doesn't develop because you're not thorough enough – the supposed link between poor hygiene and this type of cyst is a myth and isn't remotely helpful. Quite the opposite: it offers no real explanation and simply creates shame and guilt.

The truth is that the causes of a Bartholin's cyst aren't known with certainty. We only know that women of childbearing age are more susceptible, that the risk increases after puberty and decreases after the menopause.

What a Bartholin's cyst feels like and how it looks

Some Bartholin's cysts are so small that they change nothing about how you feel. It doesn't hurt, it isn't bothersome – you may not notice at all that you have a cyst. This is the asymptomatic Bartholin's cyst, usually discovered by a doctor during a routine examination or a smear test.

Things are different when the size changes. If the Bartholin's cyst grows, it can cause symptoms. At first you might simply notice while washing or touching yourself that a swelling has appeared next to the vagina. Or you might notice that one of the labia majora looks more swollen than the other. That's because the cyst usually occurs on one side only. It can feel soft and be either completely painless or only slightly tender.

Clear warning signs appear when the cyst continues to grow and we're already talking about an inflamed Bartholin's cyst. At that point the symptoms can no longer be ignored. A large cyst can be bothersome when walking or sitting, when wearing jeans or tight clothing, and even during sex.

Cyst or abscess? How to tell them apart

Let's say you've already noticed a swelling at the vaginal opening. The next question is: how do you know whether it's just a cyst or whether an abscess has formed?

Of course, a doctor can give you a clear answer within minutes. But if you'd like to know how to tell a cyst from an abscess before your appointment, here are some pointers:

• A simple cyst is soft and causes no pain, at most slight tenderness. The swelling shows no marked redness, and there's usually no fever.
• With a Bartholin's abscess, when the cyst becomes infected, severe pain can be the first sign. The area may swell, feel warm and turn red, and the skin may look taut. Fever can also occur, and the pain can escalate very quickly. An infection can develop fully within a matter of days.

And one more thing: if the swelling appeared suddenly and is very painful, see a doctor straight away. It may be bartholinitis – inflammation of the Bartholin's gland – which occurs when the area becomes infected.

What else the swelling could be

Naturally, not every swelling in the intimate area automatically means a Bartholin's cyst. It could just as easily be a sebaceous cyst, folliculitis or an inflamed spot. A lipoma, hidradenitis suppurativa or an epidermal inclusion cyst are equally possible. More rarely, it could also be a tumorous change.

For people without medical training, it's often difficult to tell these conditions apart. Don't try to diagnose yourself based purely on information and photos of Bartholin's cysts found online. Their appearance can vary enormously, as can symptoms and causes – only a specialist can determine with certainty what it is, following an examination.

What you can do at home for a Bartholin's cyst (and what you should never do)

What do you do when you feel a swelling in such an intimate place? We're women ourselves and we know the first instinct is to do something about it – preferably at home, in the comfort of your own privacy. And there genuinely are a few things that can help ease the discomfort. But there are also things you shouldn't even attempt, because they do more harm than good.

What you can do at home:

• Try sitz baths in warm (not hot) water for 10–20 minutes, 3–4 times a day, over several days.
• Apply a warm compress locally to soothe the area if you haven't time for sitz baths.
• Use products for gentle intimate hygiene, for example fragrance-free pads and tampons during your period.
• Take a standard painkiller to relieve the pain.
• Wear loose cotton underwear that doesn't press on the area.

What you should NEVER attempt at home:

• Don't try to squeeze, pierce or drain the cyst yourself – this increases the risk of infection.
• Don't use steroid creams (such as Nidoflor for a Bartholin's cyst) or antibiotics off your own bat. Self-medication can alter the symptoms without treating the underlying cause – meaning it can delay medical assessment of a possible abscess and the appropriate treatment.
• Nor should you take antibiotics left over from an old prescription. Only the treatment prescribed to you for this specific case is recommended.
• Don't do vaginal douches with teas, compresses or other home remedies involving garlic or vinegar. They can worsen irritation and throw your intimate flora even further out of balance.
• Don't wear tight jeans and don't sit for long periods on hard surfaces such as chairs or a bicycle saddle, to avoid discomfort from pressure or friction.

In short: what you need to know about home measures is that sitz baths can help, ease the discomfort and encourage small cysts to drain spontaneously. There's no robust evidence, however, that home remedies can cure a large cyst or an abscess.

Don't try to treat yourself – you don't have to manage this alone. If the cyst hasn't improved after a few days, it's time for a doctor's appointment rather than another round of natural remedies.

When to see a doctor and when it's an emergency

You've hoped and hoped that the swelling would go away on its own. Up to a point. What next? How do you know that point has been reached, when it's time to see a doctor, and how urgent the examination is? Let's take it step by step.

At the start, with a small, symptom-free swelling, you'll probably wait and see. And sometimes it really does disappear. Sometimes, though, it doesn't. Sometimes the swelling persists or grows, disappears and comes back, or starts to hurt more and more. From that point on, it's clear that you shouldn't be left alone with your questions any longer. But how urgently do you need to see a doctor?

• Book an appointment with a gynaecologist if:
  • the cyst persists even after a few days of sitz baths.
  • a cyst had gone away and has now returned.
  • a new swelling appears, even if it doesn't hurt and doesn't change.
• See a gynaecologist urgently and seek medical help as quickly as possible if:
  • you have severe pain that's escalating rapidly.
  • you develop a fever.
  • the swelling is very painful to touch.
  • the cyst is making it difficult for you to walk or pass urine.
  • there's pus-like discharge.

There's one more situation in which you shouldn't put off a gynaecological examination. If you're over 40 and notice any new change in the vulval area, have it checked as soon as possible, because there's a risk of Bartholin's gland carcinoma. That doesn't automatically mean that's what it is – cancer of the Bartholin's gland is very rare (statistics put it at under 2% of vulval cancers), and cysts and other benign changes are far more common. But it's a precaution and part of the routine assessment of any new lesion. With a biopsy, a doctor can rule out more serious conditions.

How the diagnosis is made

A Bartholin's cyst is usually diagnosed by clinical examination alone – so you'll need to book an appointment for a gynaecological examination. If you've been putting that appointment off again and again, let's look at why. What are you afraid of? Are you embarrassed that you've noticed a swelling? Are you worried you don't know what happens during the examination, or that it will be painful? Let's put your mind at rest on all these points.

Firstly, as already mentioned, the cyst forms because the Bartholin's gland duct becomes blocked. Its appearance says nothing about your hygiene, your habits or your morals – so there's no reason to feel ashamed. What's more, it's absolutely not the doctor's job to judge you, but to assess the situation and offer you solutions.

And while we're on the subject of gynaecological examinations: there's nothing frightening or painful about them either. In most cases the doctor simply looks at the swelling and palpates it to assess its size, consistency and tenderness. It takes just a few minutes and, in ordinary cases, doesn't require a subsequent ultrasound or MRI scan.

Depending on the findings, the following may then be recommended:

• A swab of the vaginal secretion to rule out a sexually transmitted infection.
• A culture from the abscess contents, if an abscess has formed.
• In certain cases a biopsy, for example if the lesion looks atypical in patients over 40.

Medical treatment of a Bartholin's cyst

A small Bartholin's cyst without symptoms isn't treated. Usually it simply needs monitoring so that any changes in size or appearance are picked up early.

In all other cases, treatment depends on size and symptoms. If the cyst has become infected, or if pain or other complaints arise, treatment can range from a course of antibiotics to various surgical procedures.

Antibiotics – when they're needed (and when they're not)

Antibiotics may be prescribed for a Bartholin's cyst if it has become infected and an abscess has formed, or if there's a sexually transmitted infection. The antibiotic alone doesn't simply make the cyst disappear; it treats the accompanying infection.

That makes it all the more important not to use an antibiotic left over from an old prescription – because this time there could be a different infection requiring a different antibiotic. Likewise, an antibiotic isn't taken preventively or without a prescription. Again: its job is to treat an infection, and the type and dosage must be determined by a doctor on a case-by-case basis. Sometimes, once an abscess has been adequately drained, no antibiotic is needed at all.

Incision and drainage with a Word catheter

If the cyst is painful, gets in the way when walking, grows noticeably larger or shows clear signs of infection, treatment usually involves drainage. One of the most common approaches uses a catheter.

How does the procedure work? Under local anaesthetic, a small incision is made through which the fluid can drain. A very thin tube with a small balloon at the end is then inserted through this opening. This so-called Word catheter stays in place for at least 4 weeks. During this time a new drainage channel forms, reducing the risk of the duct blocking again.

Don't be put off by the idea of the catheter staying in place. It's a small device that most women barely notice after the first few days. So you can walk, work and get on with your daily life quite comfortably.

Marsupialisation

Marsupialisation of a Bartholin's cyst is recommended mainly for recurrent cysts or abscesses – in other words, when the cyst keeps coming back. The procedure is usually performed under local anaesthetic, less often under general anaesthetic.

What does marsupialisation involve? An incision is made and the fluid is drained; the edges of the cyst are then stitched to the surrounding skin, leaving a small permanent opening of under 6 mm. The gland can continue to drain through this opening, which reduces the risk of recurrence.

Removal of the Bartholin's gland

As a last resort, if the cyst keeps recurring and doesn't respond to any other treatment, surgery for the Bartholin's cyst may be considered. This involves surgically removing the entire gland.

It's a more major procedure because the gland is removed completely – which also means a higher risk of bleeding or scarring. That's precisely why it's considered a last option and is only carried out once all other forms of treatment have failed.

And because we know this question will cross your mind at some point: no, removing the Bartholin's gland won't significantly affect your sex life. Losing a single gland has no serious impact on lubrication, because the other Bartholin's gland remains functional.

Recovery after the procedure

If you've had a surgical procedure to treat the cyst – whether drainage alone, marsupialisation or removal – there are a few things to bear in mind during recovery from Bartholin's cyst surgery:

• First of all, you should know that some discomfort over a few days is normal.
• Sitz baths and painkillers, where recommended by your doctor, will help you maintain gentle hygiene and ease the pain.
• Loose underwear and avoiding hard surfaces, such as a bicycle saddle, will make the recovery period more comfortable.
• You'll need to take a break from sex and from using tampons until your doctor confirms that both are fine again.
• With a Word catheter, this break extends until it's removed. But the catheter has an advantage too: recovery is generally considerably easier. According to StatPearls, only 33% of women with a Word catheter needed painkillers in the first 24 hours – compared with 74% after marsupialisation.

What Bartholin's cyst surgery costs

There's no universal figure for the cost of Bartholin's cyst surgery. Costs depend on factors such as:

• The type of procedure: Word catheter, marsupialisation or removal.
• The type of anaesthetic: local or general.
• The city and the clinic you choose.

Within the public health system, certain procedures may be covered depending on the situation and the facility. The most reliable information, though, will come from speaking directly to your GP, your gynaecologist or the clinic where the treatment is to take place. Clarify what's included in the price and ask for a cost breakdown so you know exactly what expenses to expect.

What happens if the Bartholin's cyst bursts on its own

A Bartholin's cyst can open spontaneously, even if you've done nothing to trigger it. This can happen in the most mundane moments – on the loo, for example, when you notice that the swelling has suddenly got smaller and there's fluid on the paper.

If it was a simple cyst, this fluid may be clear or slightly yellowish. With an abscess, pus may drain out, sometimes with an unpleasant smell. After spontaneous drainage, the pain usually eases immediately.

The cyst opening and the fluid draining away may bring relief in the moment and aren't a medical emergency – but nor do they mean the problem is solved. The fact that the cyst has burst once is no guarantee it won't form again. The gland's duct may remain blocked, and the cyst can come back.

So what should you do after something like this?

• Wash the area gently with lukewarm water.
• Use a pad or a clean compress to absorb the discharge.
• Don't squeeze or press on the swelling to get "everything out".
• Book an appointment within the next few days, especially if pus has drained, you have a fever or the wound doesn't seem to be closing.

Does a Bartholin's cyst come back?

Yes, a Bartholin's cyst can recur regardless of the treatment method previously used. But the statistics are reassuring, because for most women it doesn't.

One year after the procedure, the recurrence rate is around 12% following treatment with a Word catheter and 10% after marsupialisation – a difference considered comparable in the literature (StatPearls). Put another way: over 85% of women experience no second episode in the first year.

The reason for a recurrence, when it happens, is that even after the cyst has been drained, the Bartholin's gland retains its tendency to become blocked. If a cyst occurs repeatedly, a more definitive treatment such as marsupialisation or removal of the gland may be considered. That doesn't mean the original treatment failed. Some people are simply more prone to recurrence, and then a treatment that works long term is needed. The goal, ultimately, is to reduce the likelihood of a new episode and help you feel like yourself again.

Bartholin's cyst in pregnancy

One of the questions that stood out when we looked through medical forums is: can you still get pregnant with a Bartholin's cyst, and can it affect the pregnancy? It is genuinely frightening to think that any change in the intimate area might affect fertility or the baby. But the answer is reassuring once again: an uncomplicated cyst neither prevents pregnancy from occurring nor affects its course or a vaginal birth.

During pregnancy, the most conservative approach possible is preferred. As a rule, sitz baths are recommended or, if necessary, drainage under local anaesthetic. More major procedures are usually postponed until after the birth, and antibiotics, if needed, are chosen to be as compatible with pregnancy as possible.

After giving birth, some women develop a Bartholin's cyst, since local injuries – including an episiotomy – are among the factors associated with blockage of the gland.

Everyday life with a Bartholin's cyst

Another question that comes up frequently in medical forums is whether sex is off limits or painful for women with a Bartholin's cyst. Can you still enjoy intimate moments as you did before? Can you live normally with it?

In most cases the answer is yes. Yes, you can lead a normal life with a Bartholin's cyst, particularly if it's small. You just need to listen to your body and not force anything if discomfort arises.

If you're not in pain, sex isn't off limits because of the cyst alone. There's no risk of passing it to a partner, because it isn't contagious. The few situations in which a break from sex is recommended are:

• When the cyst is inflamed – this can increase irritation and make intercourse painful.
• After a surgical procedure, during the recovery period, as advised by your doctor.

During your period you can use tampons and menstrual cups without worry, as the cyst is on the outside and not in the vaginal canal. But as in the example above: if the area is swollen and tender, insertion can become uncomfortable, and a pad is the more suitable alternative. Likewise, after a procedure: only go back to tampons once your doctor gives you the go-ahead.

Otherwise, simply stick to cotton underwear and loose clothing, and avoid sitting for long periods on hard surfaces, so that your days are as comfortable as possible even with this diagnosis.

Can a Bartholin's cyst be prevented?

Since the exact mechanism by which the Bartholin's gland becomes blocked hasn't been established, and we therefore don't know the precise causes, there's currently no proven way to prevent a Bartholin's cyst from forming.

What you can do, however, is reduce your exposure to the main associated factors:

• Protect yourself during every sexual encounter. Safer sex can lower the risk of sexually transmitted infections, which play a role in the development of an abscess.
• Establish a gentle intimate care routine using the kindest products you can find. Skip vaginal douching and avoid fragranced products, which can disrupt the vaginal flora and worsen irritation.
  • Don't mistake care for guaranteed prevention. Intimate hygiene products can support comfort and the balance of the vaginal flora, but they don't treat or prevent a Bartholin's cyst.

• Never put off your annual gynaecological check-up – it can pick up a small cyst before it causes any symptoms.

  

Frequently asked questions

The course of a Bartholin's cyst can look different from one person to the next. It may stay small without bothering you at all. Or it may grow larger, become inflamed and burst on its own. That's why the same question about symptoms or treatment can have different answers depending on how the cyst looks and behaves. Below you'll find answers to the most common questions about bartholinitis and Bartholin's cysts.

Does a Bartholin's cyst go away on its own?

Yes, a small, uninfected Bartholin's cyst can disappear on its own without treatment. Some cysts drain spontaneously and the symptoms improve, especially with sitz baths and warm compresses. Cysts that persist, grow or keep recurring should be assessed by a doctor.

Does a Bartholin's cyst hurt?

A simple Bartholin's cyst can be completely painless. Pain occurs mainly when the cyst grows and presses on the surrounding tissue, or when it becomes infected and an abscess forms. In that case the area can become very tender, red, swollen and warm.

Is a Bartholin's cyst cancer?

A Bartholin's cyst doesn't automatically mean cancer and is usually a benign change. Even so, any new change in the intimate area – particularly after the age of 40 – should be assessed by a doctor. If it shows atypical features, a biopsy may be recommended to rule out malignant causes.

Can I lance a Bartholin's cyst myself?

No, don't try to lance, burst or drain the cyst yourself. Squeezing it or using a sharp object can damage the tissue and encourage infection. If it opens on its own, wash the area with warm water and let the fluid drain without pressing.

How long does a Bartholin's cyst last?

The duration varies, but a Bartholin's cyst can resolve within a few weeks. A small cyst may disappear without treatment. With a larger or infected cyst, a medical procedure may be needed. If there's no improvement or the cyst continues to grow, book a gynaecological appointment.

Is it passed on through sex?

No, a Bartholin's cyst isn't a sexually transmitted infection and isn't passed on through intercourse. However, since some sexually transmitted conditions such as gonorrhoea or chlamydia can be involved in inflammation of the gland, testing for sexually transmitted infections may also be recommended.

What's the difference between a Bartholin's cyst and bartholinitis?

A Bartholin's cyst is a collection of fluid caused by blockage of the gland's duct. Bartholinitis refers to inflammation of the Bartholin's gland itself. If infection is added to the inflammation and pus collects, an abscess can form, which is generally far more painful than a simple cyst.

Which antibiotic is used for a Bartholin's cyst?

There's no universally recommended antibiotic for every Bartholin's cyst. A simple, uninfected cyst, for instance, isn't treated with antibiotics at all. Antibiotics are prescribed when there's an infection, such as an abscess or a sexually transmitted condition – and the medication depends on the suspected cause.

Sources

1. NHS — Bartholin's cyst (last reviewed: 23 April 2025) — https://www.nhs.uk/conditions/bartholins-cyst/
2. StatPearls / NCBI Bookshelf — Bartholin Gland Cyst — https://www.ncbi.nlm.nih.gov/books/NBK532271/
3. Mayo Clinic — Bartholin's cyst — Symptoms & causes — https://www.mayoclinic.org/diseases-conditions/bartholin-cyst/symptoms-causes/syc-20369976
4. Cleveland Clinic — Bartholin Cyst: Causes, Symptoms & Treatment — https://my.clevelandclinic.org/health/diseases/17737-bartholin-cyst
5. American Family Physician (AAFP) — Omole F. et al., Management of Bartholin's Duct Cyst and Gland Abscess — https://www.aafp.org/afp/2003/0701/p135
6. Lee MY et al. — Clinical Pathology of Bartholin's Glands: A Review of the Literature, Curr Urol, 2015 — https://pmc.ncbi.nlm.nih.gov/articles/PMC4483306/
7. Harvard Health Publishing — Bartholin's gland cyst (last reviewed: 14 February 2024)  — https://www.health.harvard.edu/a_to_z/bartholins-gland-cyst-a-to-z
8. NIH — A Report of Two Cases of "Giant Bartholin Gland Cysts" Successfully Treated by Excision with Review of Literature — https://pmc.ncbi.nlm.nih.gov/articles/PMC5535437/

Image credits: Pexels.com