Are Bartholin Cysts Dangerous?

Key Takeaways

• Most Bartholin cysts are benign, small, and painless — often managed with sitz baths or simple observation.

• Rapid growth, worsening pain, redness, or fever usually points to infection and possible abscess that needs prompt care.

• A new Bartholin-like lump in someone over 40 should be checked quickly to exclude cancer.

• Recurrent, large, or painful cysts commonly need procedures such as drainage, a Word catheter, marsupialization, or excision.

• If there’s discharge, systemic symptoms, or STI concern, clinicians will take cultures and start antibiotics when appropriate.

What Is a Bartholin Cyst and How Does It Form?

How does a Bartholin cyst form? It starts when one of the small glands beside the vaginal opening develops a duct blockage. The gland’s mucinous fluid then backs up and creates a mucus-filled lump that can be as small as a pea or as large as a golf ball. Most cysts are soft, solitary, and not painful, so they only need simple home care. A blocked duct can cause gradual swelling and sometimes discomfort as the cyst enlarges. If bacteria reach the trapped fluid, the cyst can become an abscess, causing pain, redness, and fever and requiring medical treatment. Cysts may appear on one or both sides and can recur after they resolve, which may lead clinicians to recommend further treatment.

Signs That a Bartholin Cyst May Be Dangerous

After explaining how Bartholin cysts form, it’s important to know which features suggest a more serious issue. Warning signs include rapid enlargement, increasing tenderness, local redness, warmth, and fever — all of which point to infection or an abscess that needs timely care. A painful lump that persists beyond 2–3 days or causes severe pain should be evaluated. Recurrence or a large cyst that requires drainage or gland removal raises the chance of complications. Any new Bartholin-like mass in someone over 40 is concerning for cancer and should be assessed without delay.

How do clinicians decide whether a Bartholin cyst is a simple, low-risk lesion or needs urgent care? The evaluation is mainly clinical: a vulvar inspection and gentle palpation to check size, tenderness, fluctuation, redness, and any systemic signs. A painless, mobile lump without erythema usually represents a noninfected cyst; severe pain, fever, or fluctuance suggests an abscess and higher infection risk. If there’s discharge, cultures can help identify bacterial or sexually transmitted causes. Imaging is rarely required. Patients over 40, a solid/atypical mass, or recurrent lesions often prompt biopsy or specialist referral to exclude malignancy. Clinicians also consider other possibilities (Skene’s gland cyst, sebaceous cyst) to refine the diagnosis. Past recurrences and systemic symptoms guide urgency and further testing.

Treatment Options for Cysts and Abscesses

Treatment is tailored to symptoms, size, and infection status when a Bartholin cyst is symptomatic or has become an abscess. Small, noninfected cysts commonly require no procedure and can be managed with observation and warm sitz baths for comfort. Large or infected lesions usually need drainage under local anesthesia to relieve pain and remove pus. Options include simple incision and drainage, placement of a Word catheter to keep the tract open for weeks, or marsupialization to create a longer-lasting opening and lower recurrence risk. Antibiotics are used when infection is present or an STI is suspected, and they are combined with drainage when indicated. Recurrent or suspicious cases may lead to gland excision if other treatments fail.

When to Seek Immediate Medical Care

Which signs mean you should seek immediate medical attention? Rapid onset of severe pain, quick enlargement over hours to days, visible pus, increasing warmth, spreading redness, or fever suggest infection or abscess and warrant urgent evaluation. A painful, hot, or rapidly worsening lump, feeling generally unwell, or having a high fever all require prompt care. Anyone over 40 with a new lump near the vaginal opening should seek urgent assessment because malignancy, while uncommon, is more likely in this age group. Pregnant people, those who are immunocompromised, or anyone who is severely unwell should get immediate medical review for any Bartholin cyst symptoms. Nonpainful, stable lumps that persist beyond 2–3 days still deserve timely outpatient evaluation to rule out other conditions.