You will probably never hear about this lady part until there’s something wrong with yours. But my post about Bartholin glands and Bartholin abscess is my number one commented on and asked about on my Dr. Sara Twogood’s Ladyparts Blog so I thought it was time to share here too.
Only about 2-3% of women have problems with their Bartholin glands, so this might be the only time you ever hear they even exist! That also means there is not a whole lot of information out there – confusing an already difficult time if you’re having any issues.
What and where are the Bartholin glands?
Bartholin glands sit right next to the vagina. There’s two of them – if your vaginal opening is a clock, your Bartholin glands are the 4 and the 8. They’re very small (less than 0.5 cm) and have the glamorous job of secreting mucus for vaginal lubrication.
What happens when Bartholin glands have problems?
Bartholin gland cyst
The more common problem is a Bartholin gland cyst. People often do not even notice it’s there because most are asymptomatic. There may be a bulge on the side of your vagina. It doesn’t hurt, but it can be uncomfortable, especially the larger ones (4cm or more). You might notice it more during intercourse. Usually only 1 side is affected at a time, so if you see or feel a lump on one side of your vulvar area, that may clue you in (and of course you see your gynecologist if you notice a lump on the vulva that doesn’t go away on its own).
Bartholin gland abscess
The more troublesome problem is when the duct or cyst becomes infected – called a Bartholin duct abscess. The infection is usually polymicrobial – meaning many different types of bacteria are responsible. Most of these bacteria are usually harmless and live in your vagina without causing problems. Less than a third of the infections are caused by sexually transmitted infections, which is the burning question (who gave this to me!??) when women have any infection of their lady parts.
These abscesses hurt really, really bad. Can’t walk, can’t even sit comfortably … and forget about sex. The side of the vagina, once again, at 4 or 8 o’clock, is red and tender and swollen. Pus may drain from the tender site.
Both problems – the cyst or the abscess – can be treated with a procedure that drains the cyst or abscess. A little catheter or stitches are placed to hold the drainage site open for a few weeks. Yes, a few weeks.
Yes, I know it sounds awful.
I would recommend seeing an OBGYN for this, even though emergency room doctors sometimes do the procedure themselves if you end up in the emergency room.
With a cyst that’s asymptomatic, your doctor may recommend just watching it.
With an abscess, believe me, you’ll want treatment right away.
Anywhere between 3-20% of women have recurrent Bartholin abscesses, which, as you can imagine, can completely take over your life. Chance of recurrence depends on the procedure you went through to get rid of the first one. The procedure with stitches (called marsupialization) has a higher recurrence rate, but recovery is quicker and easier compared to the catheter treatment. Your doctor will recommend one or the other. In women with recurrent abscesses, surgical removal of the entire duct is usually recommended once the inflammation calms down (the surgery is less gruesome than you are probably imaging).
The last, very rare, problem of the Bartholin duct is cancer. We’re talking less than 1 in 1,000,000 women. To be safe, your doctor may recommend a biopsy if you are 35 or older and have a cyst or abscess (don’t worry, it will be done at the same time as the treatment).
I am a board certified OBGYN at Cedars Sinai in Los Angeles.
I am co-founder of Female Health Education, a platform offering digital courses, striving to empower females through health education.
My passion is promoting and demystifying health information to the public. My blog, Dr. Sara Twogood’s LadyParts Blog, provides comprehensive information about fertility, pregnancy, and gynecology topics. I am on the medical board for the period tracker app Flo; contribute as a medical expert for pregnancy app and website The Bump; and serve on the Byrdie Beauty and Wellness Review Board (Byrdie.com). I have been featured as an expert for the podcasts The Dream and Her body, Her Story and quoted in numerous online and print publications.
I am honored to be named “Top Doctor” in Los Angeles magazine for years.