A Bartholin cyst develops when the gland’s drainage duct becomes blocked, causing fluid to collect inside the gland. You may have little or no pain at first, and the lump may only become noticeable as it gradually increases in size.
A Bartholin abscess develops when the gland or an existing cyst becomes infected and fills with pus. You are more likely to experience severe pain, swelling, tenderness and difficulty walking, sitting or having sex. Understanding the difference can help you recognise when you should seek medical advice. However, you should always have a new vulval lump assessed because other conditions can look similar to a Bartholin cyst or abscess.
What Are the Bartholin Glands?
If you have never heard of the Bartholin glands, they are two small glands located on either side of the lower vaginal opening within the vulval area. You usually cannot see or feel them because they are small and release a small amount of lubricating fluid through tiny ducts.
When one of these ducts becomes blocked, fluid can build up and form a Bartholin cyst. You may notice a lump on one side of the vaginal opening, which can stay small or gradually become larger and uncomfortable. A new swelling should be checked by a healthcare professional to confirm the cause and rule out other vulval conditions.
What Is a Bartholin Cyst?
If you have a Bartholin cyst, it means fluid has collected because the small duct that normally drains mucus from the gland has become blocked. A small cyst may not cause any symptoms, and you may only notice a soft lump near the opening of your vagina.
As the cyst grows, you may feel pressure or discomfort when you walk, sit, exercise or have penetrative sex. Because a cyst is not usually infected, you may not have redness, fever or feel unwell unless an infection develops.
What Is a Bartholin Abscess?
If you have a Bartholin abscess, it means a Bartholin gland or cyst has become infected and filled with pus. Compared with a simple cyst, an abscess is usually more painful and may cause significant swelling, warmth, redness and tenderness.
You may notice the lump becoming very painful within a short time, making it difficult to sit, walk or carry out normal activities. If you develop pus, an unpleasant smell, fever, chills or feel generally unwell, you should seek medical advice because you may need treatment such as drainage, antibiotics or both.
Bartholin Cyst and Abscess at a Glance
The most obvious difference is usually the presence of infection. A cyst can be painless or mildly uncomfortable, whereas an abscess is more likely to be intensely painful and inflamed.
| Feature | Bartholin cyst | Bartholin abscess |
| What it contains | Trapped gland fluid | Pus caused by infection |
| Pain | Often painless or mildly uncomfortable | Usually painful and tender |
| Speed of development | May enlarge gradually | Can worsen rapidly over hours or days |
| Skin changes | Skin may appear normal | Redness, heat and swelling may occur |
| Effect on movement | Large cysts can cause pressure | Walking and sitting can become very painful |
| Discharge | Usually none unless the cyst drains | Pus or unpleasant-smelling fluid may leak |
| General illness | Unusual | Fever or feeling unwell may occur |
| Initial management | Observation may be appropriate | Prompt assessment and drainage may be needed |
| Antibiotics | Not normally needed without infection | Used selectively according to infection signs |
| Recurrence | Possible | Possible because Bartholin cysts and abscesses can recur even after treatment |
The boundary is not always completely clear. A cyst can be mildly tender without infection, while an abscess may begin draining before you are examined and appear less swollen.
A clinician will consider the appearance, temperature, tenderness and contents of the lump. Your symptoms and how quickly they developed can also help distinguish a cyst from an abscess.
What Causes a Bartholin Cyst?
If you have a Bartholin cyst, it usually develops because the small duct that drains fluid from the gland becomes blocked. In many cases, your doctor may not be able to identify exactly why this blockage has happened.
The blockage may be linked to inflammation, irritation, thickened gland fluid or a previous infection, although you may not remember any specific cause. It is not caused by poor hygiene, and you can develop a Bartholin cyst even if you are not sexually active.
What Causes a Bartholin Abscess?
If you have a Bartholin abscess, it usually develops when bacteria infect fluid trapped inside a blocked gland or cyst. Bartholin abscesses are usually caused by bacteria that normally live on the skin, genital area or bowel. In some cases, sexually transmitted infections such as gonorrhoea or chlamydia may contribute, but many Bartholin abscesses are not caused by an STI.
You may also need sexual health testing if your clinician thinks an STI could be contributing, but having an abscess does not automatically mean you have an STI. The cyst or abscess itself is not something you pass to another person, although an infection linked to it may sometimes be sexually transmitted.
What Does a Bartholin Cyst Feel Like?
If you have a Bartholin cyst, you may notice a soft lump on one side near the opening of your vagina. A small cyst may not cause any pain, but you might notice fullness, swelling or a change in the appearance of one side of the vaginal opening.
As the cyst becomes larger, you may feel pressure or discomfort, especially when you sit, walk for long periods or wear tight clothing. You may also notice discomfort during penetrative sex if pressure is placed on the swollen area.
What Does a Bartholin Abscess Feel Like?
If you have a Bartholin abscess, you will usually notice much more pain compared with a simple cyst. The swelling may feel hot, tender and tense, and you may experience throbbing discomfort that makes sitting, walking or everyday activities difficult.
You may also notice pain during sex, stinging when passing urine or pus draining from the lump. If you develop fever, chills or feel generally unwell, seek medical advice promptly because this may indicate a more significant infection.
Can a Bartholin Cyst Turn into an Abscess?
If you have a Bartholin cyst, it can sometimes become infected and develop into an abscess. You may notice the lump becoming larger, warmer and much more painful, with symptoms such as redness, pus, unpleasant discharge or difficulty sitting and walking.
Not every cyst turns into an abscess, and some may remain small or settle without treatment. Avoid squeezing or trying to drain the swelling yourself, as this can increase irritation, introduce infection and cause further problems.
Can a Cyst or Abscess Burst on Its Own?
A Bartholin cyst or abscess can sometimes burst and drain by itself, which may relieve pain and pressure quickly. Using a clean sanitary pad can help absorb fluid and keep the area clean while it heals.
- Avoid Squeezing: Do not press or insert anything into the opening, as this can worsen irritation or infection.
- Monitor Symptoms: Seek medical advice if the lump persists, pain continues, discharge smells unpleasant, or you develop fever or spreading redness.
- Supportive Care: Keeping the area clean and dry helps the healing process and reduces the risk of further infection.
- Prompt Assessment: Even if the cyst drains naturally, professional review ensures no complications develop and appropriate treatment is given.
Overall, spontaneous drainage can relieve discomfort, but careful monitoring and medical guidance are important to ensure safe recovery.
How Is a Bartholin Cyst or Abscess Diagnosed?
If you have a Bartholin cyst or abscess, your clinician will usually diagnose it by examining the vulva and asking about when the lump started, how it has changed and whether you have pain or discomfort. The position, appearance and tenderness of the swelling can help confirm whether it is likely to involve the Bartholin gland.
You should tell your clinician if you have had a previous cyst or abscess, as repeated swelling may affect your treatment options. During drainage, a sample of fluid or pus may be tested, and you may be offered STI testing when appropriate.
Clinical Tip:
A Bartholin-area lump is not always caused by a Bartholin cyst. Your clinician may examine the swelling carefully to rule out other vulval conditions, particularly if the lump is unusual, persistent or occurs after menopause.
Why Is a New Bartholin Lump After 40 Checked Carefully?
If you are over 40 and notice a new Bartholin lump, your doctor will usually assess it carefully because these glands become less active with age. A new Bartholin-area lump after the age of 40 or after menopause should be assessed carefully. Your clinician may recommend further investigation, such as a biopsy, depending on the appearance and characteristics of the swelling.
You should arrange an examination for any new vulval lump after 40 or after menopause, even if it is painless. If the lump feels firm, irregular, keeps growing or returns after treatment, your clinician may recommend further assessment rather than assuming it is a simple cyst.
When Can a Cyst Be Managed Without a Procedure?
If you have a small Bartholin cyst that is not infected and is not causing significant discomfort, your clinician may recommend monitoring it rather than treating it straight away. A watch-and-wait approach can be suitable when the diagnosis is clear and the swelling is not affecting your daily life.
You may find warm baths or a warm compress help ease mild pressure and encourage natural drainage. Seek medical advice if the lump becomes larger, painful or changes, as this may mean an infection has developed or you need further treatment.
Are Antibiotics Always Needed for an Abscess?
Antibiotics may be considered when there are signs of spreading infection, systemic illness, pregnancy, or other specific risk factors identified by your clinician. Drainage is usually the main treatment when an abscess contains trapped pus because antibiotics alone may not allow the collection to empty.
Your clinician may recommend drainage when a larger abscess has collected pus because antibiotics alone may not relieve the pressure. The right treatment for you depends on the size of the swelling, your symptoms, pregnancy status, allergies and whether there are signs of infection spreading.
How Does a Word Catheter Treat a Cyst or Abscess?
If you have a painful Bartholin cyst or abscess, a Word catheter can help drain the swelling while allowing your body to form a new drainage channel. Your clinician numbs the area, makes a small opening to release fluid or pus, and places the catheter inside the opening. The catheter is usually left in place for around 2–4 weeks to allow a new drainage channel to form, although your clinician will advise you based on your circumstances.
| Treatment option | When it may be recommended | How it works | Possible advantage |
| Observation (watchful waiting) | Small, painless, non-infected cyst | No procedure; symptoms are monitored | Avoids unnecessary treatment if the cyst settles naturally. |
| Word catheter | Symptomatic cyst or abscess requiring drainage | Drains the fluid or pus while keeping the opening open with a small catheter for several weeks | Encourages a new drainage channel to form and may reduce recurrence. |
| Marsupialisation | Recurrent cysts or abscesses, or when a Word catheter is unsuitable | Creates a permanent drainage opening by stitching the cyst edges to the surrounding skin | Can provide longer-term drainage and reduce recurrence. |
| Simple incision and drainage | Selected situations, often for temporary relief | Opens the swelling and drains its contents | Rapid symptom relief, but recurrence may be more likely because the opening can close quickly. |
The procedure usually takes around 10 to 15 minutes, and you can often go home shortly afterwards. You may continue most daily activities while the catheter is in place, but you should follow your healthcare team’s advice about exercise, sex and what to do if the catheter falls out.
Evidence Note
Clinical guidelines and studies support drainage procedures that maintain a longer-term opening, such as Word catheter placement or marsupialisation, because simple incision and drainage alone may have a higher chance of recurrence.
What Is Marsupialisation?
If you have a Bartholin cyst or abscess, marsupialisation is a procedure that helps drain the swelling and create a longer-lasting opening to reduce the chance of it returning. Your surgeon opens the cyst, removes the fluid and stitches the edges of the cyst wall to the surrounding skin so the new opening does not close too quickly.
You may have the procedure under local or general anaesthetic, depending on your situation and where it is performed. While marsupialisation can be effective, your choice between this and other treatments will depend on factors such as your previous treatment, symptoms, recovery preferences and what your clinician recommends.
Why Is Simple Incision and Drainage Often Avoided?
If you have a Bartholin cyst or abscess, simple incision and drainage involves opening the swelling, releasing the fluid and allowing the cut to heal. Although it can quickly relieve your pain and pressure, the opening may close before a new drainage pathway forms, which means the problem can come back.
Your clinician may recommend treatments such as a Word catheter or marsupialisation because they create a longer-lasting drainage route. Simple drainage may still be considered in certain situations, but your doctor will explain whether it is a temporary option or the most appropriate treatment for you.
What Is Recovery Like After Treatment?
Your recovery after Bartholin cyst or abscess treatment depends on the procedure you have had, such as natural drainage, Word catheter placement or marsupialisation. Some soreness, mild bleeding or discharge can be expected, and you should follow the pain-relief and wound-care advice provided by your healthcare team.
You can usually return to normal activities gradually, although exercise and sex may feel uncomfortable while the area heals. Contact your clinic if your pain is getting worse, bleeding becomes heavy or you develop fever, increasing redness, swelling or other signs of infection.
When Do You Need Routine or Urgent Medical Help?
If you notice a new lump in or around your vagina, you should arrange a routine appointment with your GP or gynaecologist for assessment. Although many vulval lumps are harmless, it is important to confirm the cause rather than relying on self-diagnosis. This is particularly important if you are unsure whether the swelling is in the typical Bartholin gland area. An examination can help determine whether monitoring, treatment or further investigation is needed.
You should seek urgent medical advice if the lump becomes larger, increasingly painful or develops signs of infection. Symptoms such as redness, warmth, pus, fever or feeling generally unwell may indicate a Bartholin abscess or a spreading infection. Prompt assessment can help prevent complications and ensure that you receive appropriate treatment. You should also seek medical attention if the swelling is affecting your ability to walk, sit comfortably or carry out your normal daily activities.
Key Takeaways
- Bartholin cysts are usually caused by a blocked gland duct, while abscesses involve infection and pus.
- Severe pain, redness, swelling or fever may indicate an abscess requiring medical assessment.
- Do not squeeze or attempt to drain a Bartholin lump yourself.
- Word catheter placement and marsupialisation are commonly used treatments that may help reduce recurrence, depending on your circumstances.
- Any new Bartholin-area lump after age 40 should be checked carefully.
FAQs:
1. What is the main difference between a Bartholin cyst and a Bartholin abscess?
A Bartholin cyst is a fluid-filled swelling caused by a blocked Bartholin gland duct and may cause little or no pain. A Bartholin abscess occurs when the cyst or gland becomes infected and fills with pus, usually causing significant pain, swelling, redness and tenderness.
2. Can a Bartholin cyst go away without treatment?
Yes, a small Bartholin cyst that is not infected may sometimes settle on its own or drain naturally. If it is painless and not causing problems, a clinician may recommend monitoring it rather than carrying out a procedure. However, any new vulval lump should be assessed to confirm the diagnosis.
3. How do you know if a Bartholin cyst has become an abscess?
A cyst may have developed into an abscess if the lump becomes suddenly larger, more painful, hot, swollen or tender. Other signs include pus or unpleasant-smelling discharge, fever, feeling unwell, and difficulty walking, sitting or carrying out normal activities.
4. Do Bartholin abscesses always need to be drained?
Your clinician will decide the most appropriate approach based on the size of the abscess, symptoms and your overall health. Many Bartholin abscesses require drainage because antibiotics alone may not empty a collection of trapped pus. Treatments such as a Word catheter or marsupialisation help drain the abscess and create a new opening to reduce the chance of it coming back.
5. When should you see a doctor about a Bartholin lump?
You should arrange a medical assessment for any new lump near the vaginal opening, especially if it is painful, growing, recurrent or associated with discharge or fever. A new Bartholin-area lump after the age of 40 or after menopause should always be checked carefully.
Final Thoughts: Getting the Right Care for Bartholin Cysts and Abscesses
Understanding the difference between a Bartholin cyst and a Bartholin abscess can help you recognise changes in symptoms and know when to seek medical advice. While some small, painless cysts may settle without treatment, a painful abscess often needs prompt assessment and appropriate drainage to relieve symptoms and reduce the risk of recurrence.
If you are experiencing symptoms or need further advice about finding the right Bartholin cyst treatment in London, you can contact Gynaecology Clinic London to discuss appointment arrangements, the evidence supporting different options and the questions to consider before choosing treatment.
References:
- NHS (no date) Bartholin’s cyst. Available at: https://www.nhs.uk/conditions/bartholins-cyst/
- National Institute for Health and Care Excellence (NICE) (2009) Balloon catheter insertion for Bartholin’s cyst or abscess. HealthTech guidance HTG204. Available at: https://www.nice.org.uk/guidance/htg204
- Right Decisions Scotland (no date) Management of Bartholin’s cyst and abscess, Gynaecology (066). Available at: https://rightdecisions.scot.nhs.uk/maternity-gynaecology-guidelines/gynaecology/gynaecology-guidelines/guidelines-a-z-all-gynaecology-guidelines/management-of-bartholin-s-cyst-and-abscess-gynaecology-066/
- Chelsea and Westminster Hospital NHS Foundation Trust (no date) Word catheter for Bartholin’s abscess. Available at: https://www.chelwest.nhs.uk/your-visit/patient-leaflets/womens-services/word-catheter-for-bartholins-abscess
- Kroese, J.A., van der Velde, M., Morssink, L.P. et al. (2017) ‘Word catheter and marsupialisation in women with a cyst or abscess of the Bartholin gland: the WoMan-trial, a randomised clinical trial’, BJOG: An International Journal of Obstetrics and Gynaecology, 124(2), pp.243–249. Available at: https://pubmed.ncbi.nlm.nih.gov/27640367/
- Illingworth, B.J.G., Stocking, K., Showell, M. and Kirk, E. (2020) ‘Evaluation of treatments for Bartholin’s cyst or abscess: a systematic review’, BJOG: An International Journal of Obstetrics & Gynaecology, 127(6), pp.671–678. Available at: https://pubmed.ncbi.nlm.nih.gov/31876985/
- Bakouei, F. et al. (2024) ‘Comparison of Word catheter and marsupialisation in the management of Bartholin’s glands: a systematic review and meta-analysis’, Journal of Obstetrics and Gynaecology Canada, 46(4), article 102357. Available at: https://pubmed.ncbi.nlm.nih.gov/38215822/
- Wechter, M.E., Wu, J.M., Marzano, D. and Haefner, H. (2009) ‘Management of Bartholin duct cysts and abscesses: a systematic review’, Obstetrical & Gynecological Survey, 64(6), pp.395–404. Available at: https://pubmed.ncbi.nlm.nih.gov/19445813/
- Boama, V. and Horton, J. (2016) ‘Word balloon catheter for Bartholin’s cyst and abscess as an office procedure: clinical time gained’, BMC Research Notes, 9, article 13. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4702305/