Vaginal cysts are small, fluid-filled sacs that develop on or under the vaginal wall. They affect roughly 1 in 200 women, though the true number is likely higher since many cysts cause no symptoms and go unnoticed. Most are benign, painless, and never require treatment. When they do cause problems, the issues are usually manageable.
Types of Vaginal Cysts
Not all vaginal cysts are the same. They’re classified by what tissue they originate from, and this matters because it affects where they appear, how large they grow, and whether they’re likely to cause symptoms.
Müllerian cysts are the most common type, accounting for about 44% of all vaginal cysts. They develop from tissue left over from the embryonic ducts that form the reproductive tract during fetal development. They can appear anywhere along the vaginal wall and are typically filled with mucus.
Inclusion cysts make up about 23% of cases. These form when tissue gets trapped beneath the vaginal surface after an injury, most commonly during childbirth or vaginal surgery. They tend to be small and sit on the lower or back wall of the vagina.
Gartner duct cysts account for roughly 11% of vaginal cysts. These arise from remnants of an embryonic structure called the mesonephric duct, which normally disappears during development but sometimes leaves behind small pockets of tissue. They typically appear on the side walls of the vagina.
Bartholin’s cysts form near the vaginal opening when the ducts of the Bartholin’s glands (which produce lubricating fluid) become blocked. They represent about 7% of vaginal cysts and tend to be the type most likely to become infected and painful.
What Causes Them
The cause depends on the type. Inclusion cysts have the clearest trigger: physical trauma to the vaginal wall. Tears during childbirth, episiotomies, and vaginal surgeries can all push small pieces of surface tissue beneath the vaginal lining, where they become walled off and fill with fluid. Women who’ve had vaginal deliveries or gynecological procedures are at higher risk for this type.
Müllerian and Gartner duct cysts aren’t caused by injury. They develop from embryonic tissue that was present before birth but didn’t fully dissolve during development. These cysts may be there for years before they’re noticed, often turning up incidentally during a routine pelvic exam or imaging for another reason. Bartholin’s cysts form when the gland’s drainage duct gets blocked, sometimes due to infection, sometimes without a clear cause.
Symptoms and How They Feel
Most vaginal cysts produce no symptoms at all. You may not know you have one unless a healthcare provider finds it during an exam. When cysts do cause symptoms, it’s usually because they’ve grown large enough to create pressure or because they’ve become infected.
A cyst you can feel typically presents as a small, round, soft lump on the vaginal wall. Depending on its size and location, it might cause a sensation of fullness or pressure in the vagina, discomfort during sex, or difficulty inserting a tampon. Bartholin’s cysts near the vaginal opening can make sitting or walking uncomfortable when they swell. An infected cyst (abscess) often becomes red, warm, tender, and noticeably painful, sometimes within a day or two.
How Vaginal Cysts Are Diagnosed
A pelvic exam is usually all that’s needed. Your provider can often identify a cyst by feel and visual inspection, noting its location, size, and whether it’s firm or soft. The location on the vaginal wall provides a strong clue about the type: a cyst near the vaginal opening suggests a Bartholin’s cyst, one on the side wall points toward a Gartner duct cyst, and so on.
If the cyst is large, deep, or unusual in some way, imaging with ultrasound or MRI can help determine its exact boundaries and rule out other conditions. A biopsy, where a small tissue sample is examined under a microscope, is occasionally done to confirm the type or to rule out rare conditions that can mimic a cyst, including certain tumors. Several other vulvar lesions can look like cysts on initial exam, including Skene duct cysts near the urethral opening and mucous cysts on the labia, so accurate diagnosis matters.
Treatment Options
Small, symptom-free cysts don’t need treatment. Your provider may simply note the cyst and monitor it at future exams. Many vaginal cysts stay the same size for years or even shrink on their own.
For cysts that cause discomfort, the first approach is often conservative. Soaking in a few inches of warm water (a sitz bath) several times a day for three to four days can help a small infected cyst drain on its own. This is particularly common advice for Bartholin’s cysts.
When a cyst is large, persistently painful, or infected, a minor surgical procedure may be needed. The most straightforward option is drainage: using local anesthesia, a provider makes a small incision to let the fluid out. A tiny rubber tube is sometimes placed in the opening and left for up to six weeks to prevent the cyst from refilling.
For cysts that keep coming back, a procedure called marsupialization creates a small permanent opening (about 6 millimeters) by stitching the cyst walls open. This allows ongoing drainage and significantly reduces the chance of recurrence. Complete surgical removal of the cyst is reserved for persistent cases that don’t respond to less invasive approaches and carries a somewhat higher risk of bleeding and complications.
Antibiotics are used when there’s a confirmed infection, but if the cyst is drained effectively, they may not be necessary.
Recovery After Removal
Recovery depends on the size of the cyst and the procedure used. Small cysts that are drained without stitches typically heal within a few days to two weeks. Larger cysts requiring a bigger incision or removal of deeper tissue may take several weeks to fully heal.
After any procedure, you’ll generally be advised to keep the area clean and dry, avoid strenuous exercise or contact sports until cleared, and use over-the-counter pain relievers for mild soreness and swelling. Sitz baths are especially helpful after surgical drainage of an infected cyst, keeping the area clean and promoting drainage. A follow-up visit is typically scheduled seven to ten days after surgery to check healing and remove stitches if needed.
Contact your provider after a procedure if you notice fever, severe pain, bleeding, pus or foul-smelling drainage from the site, or skin discoloration around the area. These can signal infection or other complications that need prompt attention.