What is the Bartholin’s Gland?

1. The most common question we get about the Bartholin’s gland is not really what is it, but why is mine swollen! Knowing the location of the gland can help you determine if the gland is swollen. The two Bartholin glands sit at the opening of the vagina, at approximately 4 and 8 o’clock.

2. The swelling is always proceeded by infection. If though initial infection, or debris the duct becomes obstructed, mucus produced by the gland accumulates, leading to a ballooning of the duct behind the obstruction. Bartholin’s Gland cysts are the most common cysts of the vulva.

3. You may still have an active infection that needs to be treated. Inflammation of this area can also product generalized vulvar edema and that in turn can cause further obstruction, and is more likely associated with an active infection. Bartholin duct infections settle into a soft structure usually somewhere in size between a pea and a grape that is fluid filled known as a Bartholin’s cyst. Bartholin’s cysts are usually sterile, not painful, not changing in size and, again, you can cease thinking about it.

4. Unless it drains, or is drained the swollen Bartholin’s gland will stay swollen. Many women will keep them for years, without necessarily being bothered or need further treatment

5. It would not be typical to have both glands infected at once. Bartholin duct cysts are usually unilateral, they don’t typically change with the menstrual cycle, but if infected again they will swell.

6. Neither size, or mere presence, means there is any cancer. Larger cysts may cause discomfort, typically during sexual intercourse, sitting, or when walking. A biopsy is not necessary except women over age 40, for whom some experts suggest drainage and a biopsy be performed to exclude cancer.

7. Glands can be still swollen if treatment fails. In younger women a minor procedure to hold open the duct with a catheter or by sewing open the tiny duct allows for healing and thus the gland does not reform a fluid collection is often recommended, and that is a marsupialization. Oddly, not everyone has the same kind of gland, there are many tissues that can be present on a microscopic level forming the gland, and depending on the tissue will depend on the success of the marsupialiation. Sewing the gland open is done with this technique, it can still fail and need more treatment, so don’t skip your check ups after the procedure.

8. An obstructed Bartholin duct can become infected and form an abscess and that’s why it is still swollen. If cultured the abscess will likely have E. coli, Strep, or Group B strep. STIs might be the initial cause but not always. Should your gland swell, and give you such severe pain you cannot walk, sit, or have sex, you need to be seen. When the Bartholin’s abscess is very close to the skin surface, pus may break through and drain on it’s own. Otherwise you may need to see your gynecologist for evaluation and drainage. Immediate pain relief should occur once it is drained. Women with abscesses that rupture spontaneously may only need pain medication and it’s important to keep clean and help to clear all the pus by soaking of the affected side with warm compresses or with Sitz baths.

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