Clinical features of a Bartholin cyst

A small cyst may be noticed incidentally, while a larger or infected swelling can interfere with walking, sitting or sexual activity. Examination is needed to distinguish it from other vulval lumps.

A non-infected cyst is often a smooth, rounded swelling beneath the skin at the lower part of the vaginal entrance. It may feel soft or tense and can cause pressure without severe pain. It usually affects one side because each Bartholin gland has its own duct.

When infection produces an abscess, pain and swelling may increase quickly. The skin can look red, feel warm and become extremely sensitive to touch. Pus may drain if the abscess opens, and some people develop fever or feel unwell.

A clinician considers the exact location, size, surface, tenderness, drainage and surrounding skin. They may ask when the lump appeared, whether it has recurred and whether there is fever, discharge or pain during movement.

Until assessment, avoid squeezing or puncturing the swelling. Warm sitz baths may soothe a mildly uncomfortable cyst. Treatment depends on symptoms and examination findings; an abscess often needs controlled drainage, while a small cyst without discomfort may not require an immediate procedure.

Arrange prompt care for rapidly worsening pain, fever, chills, spreading redness, foul-smelling fluid, increasing swelling or difficulty walking or sitting. These features can occur when infection has formed an abscess or is extending into nearby tissue.

Any new lump that is firm, fixed, irregular, bleeding or slow to settle should be examined rather than assumed to be a Bartholin cyst. Clinical assessment is particularly useful when the swelling is not in the usual lower area beside the vaginal opening.

Ask what features support the diagnosis, whether infection is present, if drainage is advisable and how recurrence would be managed. You can also ask how to monitor the swelling and which specific changes require urgent care.