Bartholinitis: Symptoms, Causes and Treatment

Cysts in the Bartholin's glands are very common. In the following lines we'll explain their causes, symptoms and treatment options.

The Bartholin glands, also known as the major vestibular glands, are two small glands that are located on the flanks of the vaginal introitus. Their function is to secrete mucus to serve as a lubricant during sexual intercourse. When they become clogged or infected, they enlarge and cause what is known as bartholinitis.

Since these glands are on the inside, the increase in size isn’t usually noticeable with the naked eye. It isn’t obvious to the touch, and its symptoms often go unnoticed. Fortunately, it’s a benign condition that rarely leads to complications. Next up, we’ll tell you everything you need to know about this condition.

Bartholinitis symptoms

You will most likely not develop symptoms if you have bartholinitis. This is a very common condition, so it’s almost certain that, if you’re a woman, you’ll have had it in the past without even being aware of it. Most Bartholin’s gland cysts are small, so you can’t see or feel them.

However, they do become noticeable when there’s an infection or when they increase in size disproportionately. If this occurs, according to Michigan Medicine  you may experience the following:

• Redness or swelling in the vulvar area
• Discomfort when having sex, walking, or sitting
• Fever
• Shaking chills
• Painless lump in the vicinity of the vulva

Studies indicate that symptomatic Bartholin’s cysts can reach between 2 and 4 centimeters (just under an inch to nearly 2 inches). On rare occasions, they cause irritation when urinating, although you should still be attentive to this. Infected cysts that have developed abscesses are the ones that most often manifest complications.

As Harvard Health Publishing points out, many diagnoses of bartholinitis are discovered in a routine pelvic exam. Since the signs usually disappear in two or three days, some women don’t bother to seek medical assistance nor do they consider it important (again, many cases are asymptomatic).

Causes of bartholinitis

The exact causes of bartholinitis aren’t known. This occurs when the ducts become clogged or blocked. As a result, mucus begins to accumulate and the area increases in size. The glands can also grow during or after sexual intercourse, as this is their busiest period.

In rare cases, it is caused by sexually transmitted diseases (STDs). Gonorrhea and chlamydia are the main ones related to this condition. Trauma to the area or childbirth also causes the glands to enlarge.

Researchers have found a variety of bacteria in infected cysts. Among the main ones we can highlight:

• Streptococcus
• Brucella melitensis
• Escherichia coli
• Neisseria sicca
• Pseudomonas aeruginosa

In some cases, the triggers for bartholinitis can’t be found, so they’re considered idiopathic. Most of these occur in women in the reproductive stage. If it’s detected in a woman after menopause, specialists recommend doing a biopsy to rule out malignant causes.

This doesn’t mean that all episodes after age 50 are caused by Bartholin gland cancer, only that the chances are slightly higher. They’re very rare, although it’s good to rule it out.

Treatment options

Most Bartholin’s gland cysts go untreated. They usually disappear after three or four days and, as they don’t cause symptoms, they aren’t a problem for the woman. If you feel pain, you can take over-the-counter pain relievers to counteract it; ibuprofen is your best option.

If the cause is an infection, then antibiotics will be recommended. A specialist can drain it if it’s very large, although most break and heal on their own. On rare occasions, the gland will be removed, usually when the episodes are repetitive and with acute symptoms.

Specialists may also suggest sitz baths. These consist of 10-minute soaks 3 or 4 times a day. They help relieve inflammation and speed up the recovery process. In general, it’s recommended to do them with warm water.

It isn’t uncommon for a differential diagnosis of bartholinitis to be made during the screening process. As you have seen, its symptoms are very general, so that multiple causes can explain them. Among the main ones we highlight the following:

• Other peripheral cysts (in the canal of Nuck, for example)
• Vaginal prolapse
• Endometriosis
• Adenomas
• Fibroids
• Folliculitis
• Vaginal angiomyofibroblastoma
• Myeloid sarcoma
• Myoblastoma
• Papillary hydradenoma

It’s very likely that the cyst will reappear, so patients should be aware, and ready to treat them. The specialist will also recommend a change of habits if their triggers have been determined.

If any STD has been diagnosed as its cause, it will be treated as appropriate. In short, it’s a benign condition that doesn’t usually cause major discomfort in patients. If you notice any of these symptoms, go to a specialist to rule out other possible causes.