Bartholin glands are two small, pea-sized glands located on either side of the vaginal opening. Their job is simple: they secrete fluid that helps lubricate the vagina. Most people never notice them, but when a gland’s duct gets blocked, the resulting cyst or abscess can be painful enough to make sitting uncomfortable. About 2% of women will deal with a Bartholin gland problem at some point in their lives.
Where They Are and What They Do
Each Bartholin gland sits deep in the tissue of the vulva, positioned at roughly the 4 o’clock and 8 o’clock positions relative to the vaginal opening. They’re tiny, only about 0.5 cm across, and you can’t feel them under normal circumstances. Each gland connects to the surface through a narrow duct about 2 to 2.5 cm long. These ducts open just inside the vaginal entrance, below the hymenal ring.
The glands produce small amounts of mucus that contribute to vaginal lubrication. They’re the female equivalent of the bulbourethral glands in males, which serve a similar lubricating function. When everything is working normally, the fluid drains continuously through the ducts without you ever being aware of it.
What Happens When a Duct Gets Blocked
Problems start when one of those narrow ducts becomes obstructed. Fluid backs up behind the blockage, and the duct swells into a fluid-filled sac called a Bartholin cyst. Small cysts may cause no symptoms at all. Larger ones can feel like a firm, round lump near the vaginal opening.
If bacteria get trapped in that backed-up fluid, the cyst can become infected and turn into an abscess. This is where things get uncomfortable. Symptoms of a Bartholin abscess include a tender, swollen lump on one side of the vaginal opening, redness, pain while sitting or walking, and pain during sex. Some people also notice vaginal discharge or a feeling of pressure. Fever is possible, particularly in people with weakened immune systems.
The most common bacterium behind these infections is E. coli, the same organism that causes many urinary tract infections. In one study of 224 patients with Bartholin abscesses, E. coli was the single most frequently identified pathogen. Staph and strep species were the next most common. Sexually transmitted infections like gonorrhea and chlamydia were once thought to play a larger role, but recent data suggests they account for only about 2% of cases.
Home Care for Small Cysts
Small Bartholin cysts that aren’t causing much trouble often resolve without any medical intervention. The standard home remedy is a sitz bath: sitting in a few inches of warm water several times a day for three to four days. The warmth can help a small, mildly infected cyst rupture and drain on its own. No special additives are needed in the water.
If the cyst doesn’t improve with sitz baths, keeps growing, or becomes increasingly painful, it likely needs to be drained by a healthcare provider.
How Cysts and Abscesses Are Treated
Two procedures are used most often for Bartholin cysts and abscesses that need medical treatment, and both work about equally well.
The first is a Word catheter, a small balloon-tipped tube. A provider makes a tiny incision in the cyst, drains the fluid, and inserts the catheter. The balloon is inflated to keep the new opening from closing, and the catheter stays in place for several weeks. During that time, the body forms a permanent new drainage channel around it.
The second option is marsupialization. In this procedure, a provider makes a small incision in the cyst wall and stitches the edges open so the gland can drain freely going forward. It’s typically done under local anesthesia.
A meta-analysis comparing the two approaches across 735 patients found recurrence rates of about 7.6% for the Word catheter and 9.4% for marsupialization, a difference that was not statistically significant. In practical terms, both methods carry a roughly 1-in-10 chance of the problem coming back.
Recovery After a Procedure
Recovery after marsupialization is relatively quick. Most people can return to a desk job within about a week. Physically demanding work may require two weeks or more. For four weeks after surgery, you’ll generally need to avoid sexual intercourse, tampon use, and scented soaps or lotions near the area. Rest and avoiding overexertion help the healing process.
Word catheter placement is an office procedure, so recovery time is shorter, though you’ll have the catheter in place for several weeks. Many people find it mildly uncomfortable but manageable during that period.
When a Lump Needs a Biopsy
Bartholin gland cancer is rare, but it does occur. The risk is highest in perimenopausal and postmenopausal women. Any woman in this age group who develops a new or persistent Bartholin cyst or abscess should have it biopsied to rule out carcinoma. In younger women, a straightforward cyst that responds to treatment is unlikely to be cancerous, but any mass that keeps recurring, feels unusual, or doesn’t behave like a typical cyst warrants further evaluation.