Bartholin cyst: the gland blockage beside the vaginal opening
Last updated September 3, 2026.
A Bartholin cyst is the fluid-filled swelling of the Bartholin gland (the small lubrication gland on each side of the vaginal opening): the painless-or-mild lump the size of the pea to the walnut, caused by the gland's duct blocking. It is common and benign, but when the blocked gland infects it becomes the Bartholin abscess: the very painful, hot, red swelling that needs the prompt treatment (the drainage).
What does it feel like?
The simple cyst: the soft, painless-or-mildly-uncomfortable lump at one side of the vaginal opening, noticed in the shower or on the wiping, sometimes with the awareness-or-rubbing when sitting or walking. The infected abscess: the rapid growth over the days, the severe throbbing pain (the sitting, the walking, and the sex become difficult), the redness and the heat, sometimes the fever and the generally-unwell feeling. The abscess can burst and drain itself (the relief immediate, but the review still needed).
Why does it happen?
The duct blocks (the thick mucus, the minor injury, the swelling), the gland's fluid accumulates behind the blockage, and the cyst forms. The bacteria (the ordinary skin-and-gut kinds, occasionally the sexually-transmitted kinds) can then infect the trapped fluid: the abscess. It is not caused by the poor hygiene, and it is not the cancer (the cancer of the Bartholin gland is rare, which is why the post-menopause new swelling gets the biopsy).
What is the treatment?
- The simple cyst: the no-treatment-needed kind if small and symptomless; the warm sitz-baths (the 10-15 minutes, the few times daily) help the comfort and sometimes the drainage.
- The abscess: the drainage: the small procedure (the local anesthetic) with the Word catheter (the tiny balloon-tipped catheter left for the weeks, creating the permanent drainage channel) or the marsupialization (the edges stitched open). The antibiotics added when the infection is spreading or the patient is unwell.
- The recurrences: common (the catheter or the marsupialization reduces them); the repeatedly-recurring kind gets the specialist options.
- The over-40 rule: the new Bartholin swelling after the 40 gets the biopsy at the drainage (the rare gland cancer excluded).
When does it need the prompt care?
The same-day for: the severe pain, the rapid growth, the redness-and-heat, the fever, or the difficulty walking-or-sitting (the abscess signs: the drainage cannot wait). Pymander's escalation routing is built and tested specifically for this class of decision; see the safety architecture working paper.
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Common questions
Is this an STI?
Usually not: most Bartholin cysts and abscesses come from the ordinary bacteria (the skin-and-gut kinds), and the cyst itself is just the blocked duct (nothing to do with the sex at all). The sexually-transmitted bacteria are the occasional cause, so the testing is sometimes offered at the drainage (worth taking: the treatment differs), but the finding does not mean the infidelity or the promiscuity.
Will it burst on its own?
Sometimes: the abscess can burst and drain itself (the sudden relief, the blood-and-fluid), but the review is still needed the same day-or-next (the self-drained abscess often re-accumulates without the proper drainage channel, and the antibiotics decision needs the examining). Do not squeeze it or attempt the draining yourself (the incomplete drainage worsens it).
What does the drainage involve?
The quick procedure under the local anesthetic: the small cut into the abscess (the immediate pressure-relief), then usually the Word catheter placed (the tiny balloon-tipped tube left in for the 2-to-4 weeks, letting the permanent drainage channel form so it does not refill), or the marsupialization (the edges stitched open). The worst part is the anesthetic injection; the rest is the relief.
Will it come back?
Sometimes: the recurrence after the simple bursting-or-drainage is common (the duct re-blocks), and the Word catheter or the marsupialization exists precisely to lower that risk by creating the lasting channel. The repeatedly-recurring kind gets the specialist review (the rare cases consider the gland removal), and each recurrence gets the same prompt drainage when infected.
Could it be cancer?
Overwhelmingly not at 33: the Bartholin gland cancer is rare and is the disease of the post-menopause years, which is why the guideline is the age rule: the new Bartholin swelling after the 40 gets the biopsy at the drainage (the caution), while the younger kind with the classic abscess course does not. The painful-hot-growing kind you describe is the infection's signature, not the cancer's.
How do I prevent another one?
No proven prevention exists (the duct blocks for the mundane reasons), but the practical notes: the early warm sitz-baths at the first small-lump sign (the sometimes-aborting-the-abscess measure), the not-squeezing rule, and the prompt review for any recurrence rather than the waiting-it-out (the early simple-cyst stage is the easy stage). The good vulval hygiene is reasonable but does not prevent the blockage.