What to know about a big Bartholin cyst

Bartholin glands sit near the vaginal opening and release fluid through small ducts. A cyst forms when a duct becomes blocked and fluid collects. As the cyst enlarges, it may create a soft or tense lump on one side of the vulva and cause pressure during walking, sitting or sex. If infection develops, the swelling may become hot, very tender and filled with pus; this is called an abscess. Size alone does not show whether infection is present, so an examination helps distinguish a cyst from an abscess and from other vulval lumps.

Arrange a gynaecology or primary-care appointment rather than trying to squeeze, puncture or drain the lump yourself. Warm sitz baths may ease mild discomfort while you wait, and loose clothing can reduce rubbing. A clinician will ask about pain, discharge and changes in size, then examine the area. Management depends on discomfort and signs of infection: observation may suit a cyst that is not causing discomfort, while a symptomatic or infected swelling may need drainage. Marsupialisation is one option that creates an opening so fluid can continue to drain.

Seek urgent medical care if pain becomes severe, the swelling grows quickly, pus appears, redness spreads, or you develop fever or feel generally unwell. Prompt assessment is also appropriate if the lump makes urination difficult. Book a routine examination for a persistent or recurring lump even when it is not painful, because its location and cause should be confirmed before treatment is chosen.

Ask whether the swelling appears to be a simple cyst or an abscess, whether drainage is needed, and how to care for the area afterward. If it has returned, ask which procedure may reduce repeated blockage and what changes should trigger an earlier follow-up.