What should you know about a large Bartholin cyst?

The Bartholin glands sit near the vaginal opening and help produce lubrication. If a gland duct becomes blocked, fluid can collect and form a cyst. A cyst may be smooth and uncomfortable without infection; an abscess is more likely to cause intense tenderness, redness, warmth, swelling, and possibly fever.

A clinician can examine the vulva and decide whether the swelling is a Bartholin cyst or another condition. A new lump after menopause, a firm or irregular swelling, or a lump that does not settle deserves careful assessment rather than home treatment alone.

A small, comfortable cyst may be observed with clinical advice. Warm baths can ease discomfort, but do not squeeze, puncture, or try to drain it yourself because this can worsen irritation or infection. Pain relief should be chosen according to your health and medicines.

For a persistent or painful cyst, a clinician may create a drainage opening that stays open while the area heals. Marsupialisation is one procedure used to make that opening and reduce the chance of fluid collecting again. Antibiotics may be considered when infection is present, but they do not replace drainage when an abscess needs to empty.

Seek prompt care for rapidly increasing swelling, severe vulval pain, fever, feeling unwell, spreading redness, difficulty passing urine, or inability to sit or walk comfortably. After a procedure, contact the treating team for worsening pain, heavy bleeding, fever, foul-smelling drainage, or wound redness that spreads.

Ask whether the swelling is a cyst or abscess, whether it needs drainage, which anaesthetic is planned, how to care for the area afterward, and what should happen if the lump returns.