The small Bartholin glands are a normal part of the female anatomy, but they can occasionally develop a fluid-filled sac known as a Bartholin cyst. This common gynecologic condition causes worry about discomfort and potential complications. Understanding the nature of these cysts, particularly whether they bleed, is a primary concern for those who discover this type of swelling. Examining the cyst’s contents and its relationship to surrounding tissues can clarify the risk of bleeding.
What Exactly is a Bartholin Cyst?
The Bartholin glands, also known as the greater vestibular glands, are two small structures located beneath the skin on either side of the vaginal opening. Their main purpose is to produce a mucoid secretion that lubricates the vulva and vagina. This fluid is released through thin ducts that empty near the posterior labia minora.
A Bartholin cyst forms when the opening of one of these ducts becomes obstructed, preventing the normal drainage of glandular secretions. Blockage can occur due to irritation, localized swelling, or a bacterial infection. As fluid continues to be produced but cannot escape, it backs up into the gland, causing it to swell and form a cystic mass. These cysts are generally benign and are most common in women of childbearing age.
Addressing the Bleeding Question
A typical, uncomplicated Bartholin cyst does not bleed internally because it is a collection of mucus, not blood. The fluid contained within the cyst is the normal mucoid secretion of the gland. The cyst wall itself is not highly vascular, so the formation and gradual enlargement of the cyst do not usually involve blood loss.
However, the area surrounding the Bartholin glands is highly vascular, which can introduce the possibility of bleeding under certain circumstances. The glands are located close to the vestibular bulb, which is composed of large, spongy blood vessels. Bleeding is most likely to occur if the cyst or the surrounding tissue experiences trauma or rupture.
A large, tense cyst may spontaneously rupture due to internal pressure or physical stress, such as during walking, sitting, or sexual activity. When a cyst ruptures, the small tear in the skin and the fragile cyst wall can cause minor, temporary spotting or drainage that may appear reddish or bloody. More significant bleeding can occur if severe inflammation or trauma damages the adjacent highly vascularized vulvar tissue.
When Bleeding Requires Medical Attention
While minor spotting after a cyst rupture may resolve quickly, certain signs associated with bleeding warrant immediate professional evaluation. Heavy or persistent bleeding that is more than just a few drops of spotting should be addressed by a healthcare provider. Bleeding that continues for more than a few hours or requires the constant use of a pad to absorb the flow is a warning sign.
Bleeding accompanied by systemic symptoms suggests a potential infection, which requires urgent care. These symptoms include fever, chills, or a sudden increase in localized pain, swelling, and warmth. If the lump becomes tender and painful, interfering with walking or sitting, this may indicate that the cyst has progressed into an abscess.
It is also important to recognize that bleeding near the vaginal opening may not be related to the Bartholin cyst at all. Other vulvar lesions, lacerations from trauma, or menstrual flow can be mistaken for bleeding from the cyst. In women over 40, any new mass in this area, especially one associated with bleeding, should be promptly evaluated to exclude the rare possibility of malignancy.