A cyst is a closed, capsule like sac pocket of membranous tissue that contains fluid, air, or other substances.
If the sac is filled with pus, the cyst is infected and will turn into what is called an abscess.
Cysts can grow almost anywhere in your body or under your skin.
There are many types of cysts.
Cysts vary in size from microscopic to very large.
Very large cysts can displace internal organs.
The majority are benign, but some cysts can be cancerous or precancerous.
Although cysts can appear anywhere in the body, most frequently they live in the skin, ovaries, breasts or kidneys.
In most cases, it is unusual for cysts to cause pain unless they rupture, become infected, or are inflamed.
Bartholin’s cyst – occur from swelling of the Bartholin’s glands – located on each side of the vaginal opening.
It is painless but when infected there occurs redness, heat, swelling, pain, tenderness, lumpy, discomfort while walking / sitting, pain during intercourse and fever.
A Bartholin’s cyst or abscess may recur if not treated properly and again require treatment.
These glands secrete fluid to lubricate the vagina. If bacteria infect a blocked cyst, it can develop into a Bartholin’s abscess, a painful, pus-filled swelling.
An abscess may also form without a pre-existing cyst.
Types / Clinical Forms
Simple (Non-infected) Cyst
- Soft, unilateral swelling
- Often painless or mildly tender
- May cause discomfort during sitting, walking, or sexual intercourse
Infected Cyst / Bartholin Abscess
- Severe pain, redness, warmth
- Rapid enlargement with pus
- Fever or malaise may occur
Recurrent Cyst
- Repeated duct blockage
- Often due to persistent narrowing or scarring
Chronic Fibrotic Cyst
- Thick-walled, persistent lump
- Reduced gland function
Postmenopausal Bartholin Mass: Rare, must rule out malignancy
Causes, Pathophysiology & Risk Factors
Main mechanism: duct obstruction → retained mucus → cyst → possible infection.
Known causes:
- Duct blockage (often unknown)
- Bacterial infection (E. coli, gonorrhoea, chlamydia)
- Local inflammation or trauma
- Thickened secretions
- Scar tissue narrowing the duct
Risk factors / triggers (UK/Europe context):
- Age 20–50 (reproductive years)
- Sexual activity / STI exposure
- Previous cysts
- Vulvar trauma or friction
- Poor genital hygiene
- Diabetes / immune compromise
- Tight clothing / chronic moisture
- Vaginal infections (BV, candidiasis)
Signs & Symptoms
Simple cyst:
- Painless lump near vaginal opening
- Unilateral swelling
- Mild discomfort when sitting, walking, or during intercourse (dyspareunia)
Infected abscess:
- Severe, throbbing pain
- Tender, hot swelling
- Fever / malaise
- Pus discharge
- Rapid enlargement
Most cysts occur on one side only.
Possible Complications if Untreated
- Abscess formation
- Recurrent cysts
- Chronic duct fibrosis
- Loss of gland lubrication
- Dyspareunia
- Vulvar cellulitis
- Rarely, sepsis
- Postmenopausal masses may mimic vulvar cancer
Diagnosis: Conventional evaluation:
- Clinical vulvar and pelvic exam
- STI testing
- Culture of discharge if present
- Ultrasound for uncertain masses
- Biopsy in women >40 years or atypical/recurrent cysts
Lifestyle & Preventive Care
- Breathable cotton underwear
- Avoid tight clothing
- Gentle vulvar hygiene
- Treat vaginal infections early
- Safe sex practices
- Glycemic control (for diabetes)
- Adequate hydration
- Anti-inflammatory diet
Clinical insight: Bartholin cyst is primarily a mechanical drainage disorder, not purely infection. Long-term management must restore duct patency and reduce inflammation—surgically or conservatively.
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