A Bartholin’s cyst, otherwise termed as Bartholin’s gland cyst, is a benign mass of tissue that occurs in the Bartholin’s glands, due to clogging in the ducts travelling up to these structures. The Bartholin’s glands, also known as greater vestibular glands, are a pair of pea-sized alveolar glands situated within the female reproductive system, one on each side of the opening of the vagina. Located in the internal tissues between the vagina and vulva, these glands generally cannot be seen with the naked eye. The primary function of the Bartholin’s glands is to produce a lubricating fluid to safeguard the delicate vaginal tissues in instances of sexual intercourse and avert ailments like vaginal yeast infections.

Bartholin’s cysts are a common condition in adult women of all age groups and appear as hard, sore swellings filled with fluid that may at times be painful. While smaller cysts do not prompt much discomfort, larger lumps trigger pain during intercourse or even when sitting on rigid surfaces, such as in vaginitis. These inflamed tissues within the vagina do not possess cancerous attributes but can get infected at times and turn the cyst into a pus-filled Bartholin’s abscess. In some cases, these abscesses quickly become larger in size and even result in fever, damage of vaginal tissue and seepage of pus from the protuberances.

Also Read: Vaginitis: Causes, Symptoms And Treatment
Woman with Bartholin's cysts

Causes Of Bartholin’s Cyst:

The Bartholin’s glands are responsible for synthesizing a lubricating fluid that shields the vagina from extreme friction, wear and tear during sexual activity. Once the fluid is formed, it is relayed from the Bartholin’s glands via ducts to the opening of the vagina. Bartholin’s cysts develop when mucus accrues in these ducts, thereby obstructing the flow of the lubricating secretions and resulting in the buildup of this fluid in the form of swollen lumps in the area.

Though the precise reason as to why this mucus accumulation happens in the ducts of Bartholin’s glands is yet to be determined, doctors surmise that bacterial infections are most likely the instigating factor. The causative agents are bacteria such as Chlamydia trachomatis and Neisseria gonorrhoeae which trigger sexually transmitted infections of chlamydia and gonorrhoea, as well as Escherichia coli and Streptococcus pneumoniae which induce gastrointestinal infections and pneumonia, respectively.

Also Read: Gonorrhea: Causes, Symptoms And Treatment

Risk Factors:

Bartholin’s cysts can occur in all adult women, whether they are in their youth, middle age or later years. However, it is very common in young women between the ages of 18 to 40 who are most sexually active. Aside from this, some aspects make a woman more susceptible to acquiring a Bartholin’s cyst, such as:

  • Already having encountered a Bartholin’s cyst
  • Having undertaken a surgical procedure in the vagina or vulva
  • Previously having suffered severe injury or trauma in the vaginal tissues

Symptoms:

A very small Bartholin’s cyst does not present any noticeable or tangible symptoms. If the cyst becomes enlarged, it feels sore with a growth in the vaginal opening and only mild pain.

Nevertheless, when infection arises in the Bartholin’s cyst, the swollen mass induces intense pain, posing uneasiness while having sex and discomfort, burning sensation during urination i.e. dysuria. It also leads to challenges in walking or sitting comfortably due to inflammation and tenderness in the vagina.

Diagnosis:

The doctor specializing in female reproductive disorders, a gynaecologist, performs a pelvic exam, to examine the size and nature of the Bartholin’s cyst within the vagina.

A sample of vaginal fluid secretions is obtained from the vagina or cervix by the physician to identify if any sexually transmitted infections (STIs) could be the root cause of the bulging cysts. Furthermore, in women who have attained menopause or are above the age of 40, a portion of tissue is excised from the affected segment of the vagina known as a biopsy. This helps to analyse if malignant cells are present in the region and if not, rule out the possibility of vulvar cancer.

Treatment:

For a minute cyst that does not exhibit any prominent symptoms, no specific treatment is required and the Bartholin’s cyst will gradually diminish.

Treatment is only given to women when the Bartholin’s cysts are larger, causing pain, distress and at times, even getting infected, which encompasses the following:

  • Sitz Baths: This entails immersing the body in a tub filled with hot water, for draining out the fluid-filled lumps in the Bartholin’s glands.
  • Surgical Procedures: such as drainage of the Bartholin’s cyst by incision or marsupialization protocols.
  • Prescription Medications: consisting of antibiotics for remedying a Bartholin’s abscess or if the cyst occurs owing to STIs.