MANY women have experienced that sudden discomfort – a small, tender lump near the vaginal opening that seems to appear out of nowhere. At first, it may not hurt much, but over time it can grow, become painful, and make sitting or walking almost unbearable. This is often the story of a Bartholin’s cyst, a common but often misunderstood condition affecting women of reproductive age.

What is a Bartholin’s cyst?

On each side of the vaginal opening (at 5 o’clock and 7 o’clock respectively), just beneath the skin, lies two tiny glands called the Bartholin’s glands. Their job is simple but important ­— they produce lubrication to keep the vaginal area moist during sexual activity.

Sometimes the duct that drains these glands becomes blocked, usually because of mild infection, inflammation, or thick mucus. When that happens, fluid backs up inside, forming a soft, smooth swelling – what we call a Bartholin’s cyst.

Most cysts are painless and small. Some women only notice them by accident while bathing. But others may experience discomfort during intercourse or when sitting especially if they become large (>3-4 cm).

When things get worse — The Bartholin’s abscess

If bacteria (often common vaginal or skin bacteria) infect the trapped fluid inside the cyst, it can quickly turn into a Bartholin’s abscess — a painful, swollen, red lump that can cause significant distress.

The area becomes hot, tender, and swollen, and many women describe the pain as throbbing or severe enough to interfere with walking, sitting, or sleeping. Occasionally, fever or a general feeling of being unwell can accompany it.

This abscess can enlarge rapidly, sometimes within a day or two, and in many cases it may burst on its own, releasing pus and giving temporary relief — but without proper treatment, it often returns.

Treatment options

1) For a Bartholin’s cyst (no infection present):

If the cyst is small and painless, no immediate treatment may be necessary. Warm sitz baths (sitting in a shallow basin of warm water several times a day) can help it drain naturally.

However, if it persists or becomes large and uncomfortable, your gynaecologist may need to perform a word catheter placement/ marsupilisation under sterile conditions — minor office procedures done under local anaesthesia.

A Word Catheter is a small balloon-tipped tube. An incision is made over the skin of the cyst. The cyst is then opened and the catheter is inserted into the cyst cavity and left in place for a few weeks (three to four). This keeps the duct open and allows drainage of fluid from the cyst. This is a quick and effective method.

A marsupilisation procedure involves opening the skin above the cyst. The cyst is then opened and drained. Absorbable sutures are used to stitch the skin to the cyst wall. This helps to keep the duct open and allows drainage. The healing time is usually three to four weeks. This process is effective, but is a bit more time consuming vs the Word Catheter.

2) For a Bartholin’s abscess (infected and painful):

Once infection sets in, antibiotics alone usually aren’t enough — the abscess must be drained.

Your gynaecologist will numb the area, make a small incision, and release the pus.

Pain relief, antibiotics (where needed), and good personal hygiene support recovery. Most women feel significant improvement within days of drainage.

With recurrent cases, removal of the gland may be necessary.

Recent unofficial studies have shown that the administration of energy (laser/radiofrequency) in combination with platelet rich plasma injections to the duct have been shown to decrease the incidence of recurrence.

When to see your doctor

Any painful swelling near the vagina that lasts more than a few days or causes discomfort should be checked by your gynaecologist. Do not attempt to squeeze or burst it at home, as this can worsen infection and scarring.

While Bartholin’s cysts and abscesses are common, proper medical treatment ensures safe and lasting relief, with minimal risk of recurrence.

A Bartholin’s cyst may start as a harmless swelling, but left untreated, it can turn into a painful abscess that disrupts daily life. Prompt evaluation and modern, minimally invasive treatments which are often done right in the office, can get you back to comfort quickly and confidently.

Dr Daryl Daley is a cosmetic gynaecologist and obstetrician. He is located at 3D Gynaecology Limited, 23 Tangerine Place, Kingston 10. Feel free to contact Dr Daley at ddaley@3dgynae.com.

Dr Daryl Daley.