What should you know about the pathophysiology of a Bartholin cyst?

Bartholin glands sit on either side of the lower vaginal opening and normally release lubricating fluid through narrow ducts. When a duct closes or becomes obstructed, fluid accumulates and creates a lump, often on one side. A small cyst may cause no symptoms. If bacteria multiply inside it, inflammation and trapped pus can produce an abscess.

An abscess commonly causes increasing vulval pain, tenderness, swelling, warmth, redness and difficulty sitting, walking or having sex. Vulval pain can have other causes, so a new lump should be examined rather than diagnosed by appearance alone.

Arrange an assessment for a painful, enlarging or recurrent lump. A clinician may examine the area and decide whether observation, pain relief, drainage, antibiotics or a procedure is appropriate. Do not squeeze or cut the lump yourself. Warm water soaks may ease discomfort for some people, but they should not delay care when pain or swelling is increasing.

Seek prompt care for severe pain, fever, spreading redness, pus, difficulty walking or trouble passing urine. Get urgent help if you feel very unwell or cannot urinate. A new Bartholin-area lump after menopause also deserves timely assessment, even when it is not painful.

Is this a cyst, abscess or another type of lump? Does it need drainage or testing? What can reduce recurrence, and which symptoms should lead me back for review?