A vaginal cyst is a small, fluid-filled sac that forms on or beneath the lining of the vaginal wall. Most vaginal cysts are benign, painless, and smaller than a marble. Many go unnoticed entirely and are only discovered during a routine pelvic exam. When they do cause symptoms, the experience ranges from mild pressure to pain during sex or tampon use, depending on the cyst’s size and location.
Types of Vaginal Cysts
Not all vaginal cysts form the same way. They’re classified by where they develop and what tissue they originate from.
Inclusion cysts are the most common type. They form when tissue gets trapped beneath the surface of the vaginal wall, usually after an injury. Childbirth and vaginal surgery are the two most frequent causes. These cysts tend to be small and rarely cause problems.
Gartner’s duct cysts develop from leftover embryonic tissue. During fetal development, structures called Wolffian ducts help form the urinary and reproductive systems. In female development, these ducts are supposed to disappear. When small remnants persist, they can form fluid-filled cysts along the vaginal wall, sometimes not appearing until adulthood. These typically sit on the side walls of the vagina.
Müllerian cysts also come from embryonic remnants, but from a different set of ducts involved in forming the uterus, fallopian tubes, and upper vagina. Like Gartner’s duct cysts, they can develop anywhere along the vaginal wall and are usually filled with mucus.
Bartholin’s gland cysts form near the vaginal opening, where two small glands produce fluid that helps with lubrication. When the ducts of these glands get blocked, fluid backs up and creates a cyst. Bartholin’s cysts are present in roughly 0.6 to 3 percent of women based on pelvic imaging studies, and symptomatic cases account for about 2 percent of all gynecology visits per year. Their incidence peaks around menopause.
What Causes Them
The cause depends on the type. Inclusion cysts are directly tied to physical trauma. The vaginal wall sustains small tears during childbirth or surgical procedures like episiotomy, and as the tissue heals, bits of surface tissue can become buried beneath the skin. That trapped tissue forms a pocket that fills with fluid over time.
Gartner’s duct and Müllerian cysts aren’t caused by anything you did or didn’t do. They’re the result of embryonic structures that didn’t fully dissolve during fetal development. Many people carry these remnants without ever developing a cyst.
Bartholin’s gland cysts result from a blocked duct. The blockage can happen from infection, thickened mucus, or irritation. These cysts can become infected and turn into abscesses, which are significantly more common than simple Bartholin’s cysts. Sexually transmitted infections may contribute to some cases, though this has become less common over time.
How They Feel
Most vaginal cysts produce no symptoms at all. You may feel a small, soft lump along the vaginal wall during self-examination, or your healthcare provider may discover one incidentally. The lump is typically smooth, round, and moves slightly under the skin.
When a cyst grows large enough to notice, the most common complaints are a feeling of pressure or fullness in the vagina, discomfort during sex, and difficulty inserting a tampon. Walking or sitting for long periods can also become uncomfortable if the cyst is near the vaginal opening.
Bartholin’s cysts tend to be the most symptomatic because of their location. A small one may feel like a painless pea-sized lump near the vaginal entrance. If it becomes infected and forms an abscess, it can swell rapidly over a day or two, turning red, warm, and very tender. Fever and difficulty walking or sitting are signs the cyst has become infected.
How They’re Diagnosed
A physical pelvic exam is usually enough to identify a vaginal cyst. Your provider can feel the cyst’s size, location, and texture, which often narrows down the type.
When more detail is needed, ultrasound is the most important imaging tool. It can show whether the cyst is filled with simple fluid (a typical sign of a benign cyst) or has more complex features. A benign cyst on ultrasound typically appears as a single fluid-filled pocket with no significant blood flow around it. In rare cases where the cyst is deep, unusually large, or has atypical features, MRI provides a more detailed picture.
Treatment Options
Small, painless cysts that aren’t growing generally don’t need treatment. Your provider may recommend monitoring it over time to make sure it stays stable.
For Bartholin’s cysts that are mildly symptomatic or showing early signs of infection, warm sitz baths are the first-line approach. Sitting in a few inches of warm water several times a day for three to four days can help a small infected cyst rupture and drain on its own. This works well for many first-time occurrences.
If a cyst doesn’t resolve with warm soaks, or if it’s large and painful, a minor in-office procedure can drain it. For Bartholin’s cysts specifically, a small catheter may be placed after drainage to keep the duct open and prevent the cyst from refilling. This catheter stays in place for several weeks while a new permanent drainage channel forms.
Antibiotics are not routinely needed for most Bartholin’s cysts or abscesses. They’re typically reserved for recurrent abscesses, large masses with signs of spreading infection, or cases where you have a fever or other signs of systemic illness. For cysts that keep coming back (a third episode or more), a surgical technique called marsupialization creates a permanent opening in the cyst wall so fluid can drain freely.
Inclusion cysts, Gartner’s duct cysts, and Müllerian cysts are surgically removed only if they’re causing symptoms. The procedure involves excising the entire cyst wall to reduce the chance of recurrence. Recovery is typically straightforward, with mild soreness for a week or two.
When a Cyst Becomes Concerning
The vast majority of vaginal cysts are harmless. However, certain features warrant prompt evaluation: rapid growth, a firm or hard texture rather than soft and fluid-filled, bleeding that isn’t related to your period, or a cyst that appears for the first time after menopause. In women over 40, new Bartholin’s gland masses are sometimes biopsied to rule out rare cancers of the gland tissue.
Infected cysts that progress to abscesses also need attention sooner rather than later. Signs include increasing pain, swelling, warmth, redness, and fever. An untreated abscess can grow large enough to make walking painful and, in rare cases, can spread infection to surrounding tissue.