Vaginal Cysts or Vaginal Lumps: Symptoms, Prevention, and Treatments

While taking a bath, you may be surprised to discover a soft lump on the lips of your vagina or slightly deeper inside. It’s understandable if you’re anxious about this lump because you’re not sure what it is and how it got there. While most cysts are not cancerous, the only way to be sure is to get a diagnosis from a gynaecologist.

What is a vaginal cyst?

Vaginal cysts are fluid-filled lumps that form under the skin in the vaginal area (vaginal lining) and can be filled with air, fluid, or pus. They usually form when a gland or duct becomes blocked, causing liquid or other material to collect inside.

They are usually small, around the size of a pea, and often do not require treatment. However, some types of cyst can grow to the size of an orange, which can lead to pain, itching, and an increased risk of infection. If you have a vaginal cyst, you may be able to feel it at the vaginal opening, or it may be found inside the vagina.

What are the different types of vaginal cysts and their causes?

Depending on the underlying cause, there are several types of vaginal cyst. Understanding the type of vaginal cyst you have can alleviate your concerns and help you towards the appropriate treatment.

• Inclusion cysts:

  • These are a common type of vaginal cyst that typically develops on the vaginal wall and is small in size. 

  • An inclusion cyst forms when tissue becomes trapped under the vaginal surface, usually following an injury during childbirth or vaginal surgery.

• Bartholin gland cysts:

  • These are another common type of vaginal cyst that occurs when the Bartholin glands, which produce lubricating vaginal fluid and are located near the vaginal opening, become blocked.

  • These lumps are typically painless unless they become infected. However, bacterial infections caused by E. coli or sexually transmitted infections (STIs), such as gonorrhoea or chlamydia, can cause the cyst to develop into a painful abscess filled with pus.

• Sebaceous cysts:

  • This type of cyst is less common in the vagina itself and is more typically found on the vulva (the outer genital area). Sebaceous cysts form when oil-producing glands become blocked and contain a yellowish, oily material.

• Gartner’s duct cysts:

  • These cysts occur when tiny ducts that are present during embryonic development do not disappear as they should after birth.

  • These lumps typically develop along the vaginal wall and are usually discovered during routine examinations, as they rarely cause symptoms.

• Müllerian cysts:

  • Müllerian cysts are another common type of cyst that develop from structures left behind during embryonic development. They can appear anywhere along the vaginal walls and contain fluid or mucus.

Although a vaginal cyst is usually harmless and painless, it is important to have any new lumps examined by a gynaecologist. This is particularly important because some cysts can become infected, especially if bacteria from an STI are involved.

What are the symptoms of vaginal cysts?

Vaginal cysts usually don't cause any symptoms, but if you have one, you might feel a small lump along the vaginal wall or on the vaginal lips. Although cysts are usually not painful, larger ones, especially Bartholin's gland cysts, can cause discomfort when walking, during intercourse, or when inserting a tampon.

Vaginal cysts can become infected by normal skin bacteria or an STI. An infected cyst can form an abscess, which is a pus-filled lump that can be very painful. Infected cysts may cause a fever and become extremely swollen and tender.

How are vaginal cysts diagnosed?

A vaginal cyst is usually diagnosed through a routine pelvic examination. During this examination, your obstetrician and gynaecologist (O&G) may feel the mass on the vaginal wall. They will review your medical history and ask about any symptoms you are experiencing.

They may also suggest additional tests to rule out other conditions. These tests may include:

• Taking a tissue sample from the cyst (biopsy) to rule out vaginal cancer.

• Testing the fluid from your vagina or cervix to determine if a sexually transmitted infection (STI) is present.

• Performing an MRI scan, CT scan, or pelvic ultrasound to obtain detailed images of the cyst.

If a cyst becomes infected, such as a Bartholin's gland cyst, your healthcare provider may use a swab test to collect a sample of discharge for laboratory analysis. This aids in pinpointing the specific bacteria causing the infection, as certain infections can be associated with STIs like gonorrhoea or chlamydia.

Vaginal cyst diagnosis at Thomson Women's Clinics

At Thomson Medical, our O&G doctors specialise in sexual and reproductive health. Based on the condition of your cyst, our doctors will recommend the necessary tests. Additionally, our specialists may recommend monitoring to observe any changes in the cyst's size, as these lumps can either remain the same size or grow.

If necessary, you may also be recommended a pelvic ultrasound test to help better understand the cyst's relationship to surrounding structures and distinguish whether the cyst is fluid-filled or contains solid material and to rule out other conditions with similar presentations.

Consultations are conducted in a confidential and professional setting, taking into account your concerns, and your treatment approach will be based on the type and severity of the cyst.

What to expect during your consultation:

• Private and discreet visits

• Results provided with follow-up advice

• Recommendation from a women's health specialist

• Medical imaging (ultrasound) to assess the cysts if needed

How are vaginal cysts treated?

The treatment you receive will depend on the type, size and symptoms of your cyst. Many vaginal cysts do not require treatment, but if intervention is needed, your doctor will recommend the most appropriate approach for your situation.

Non-surgical treatment for small, asymptomatic cysts:

• Watchful waiting, as many cysts resolve on their own

• Avoiding irritants, such as harsh soaps or tight clothing

• Applying warm compresses to the affected area to help alleviate discomfort

• Good hygiene practices, such as keeping the area around your vagina clean and dry

• Taking warm sitz baths and soaking in warm water 2-3 times daily for 10 to 15 minutes to encourage natural drainage

Medical treatment when infection or underlying conditions are present:

• Antibiotics for bacterial infections

• Antiviral medications for STI-related conditions.

Surgical treatment for larger, symptomatic, or infected cysts:

• Incision and drainage, with or without a catheter, under local anaesthesia.

• Marsupialisation is a surgical procedure that involves creating a permanent opening to prevent recurrence, particularly for Bartholin's cysts.

FAQ

Can I squeeze or pop the vaginal cysts?

Vaginal cysts typically go away on their own. It is advisable not to squeeze or pop the vaginal cysts yourself, as this can worsen the condition and lead to infection.

Can I get Bartholin’s cysts if I shave?

Yes, shaving can potentially lead to Bartholin’s cysts. Excessive grooming of pubic hair can irritate or infect the skin in the genital area, causing inflammation of the Bartholin’s gland. It's best to avoid excessive shaving and maintain good hygiene in your genital area.

Can I have a Bartholin’s cyst if I am a virgin?

Yes, a Bartholin’s cyst can occur in virgin women. It is caused by the obstruction of Bartholin's gland, leading to a fluid buildup, and does not require sexual intercourse to develop.

Are vaginal cysts benign?

Vaginal cysts are usually benign and not harmful, although they can sometimes be cancerous. These cysts typically occur in women of childbearing age but can also appear after menopause. Postmenopausal individuals should have any vaginal lumps checked and biopsied to rule out cancer.

How to manage a vaginal cyst by yourself?

If you're feeling uncomfortable, you can try a warm compress by applying a clean cotton cloth soaked in warm water to the affected area. Taking a sitz bath for 10-15 minutes several times a day for 3-4 days is also advisable, as it may help the cyst burst and drain on its own. If you're experiencing pain, over-the-counter painkillers can help ease your discomfort.

What happens if a Bartholin cyst bursts?

If a Bartholin cyst bursts, it might heal on its own within a few days. However, to prevent the infection from spreading, it is recommended to visit a doctor. The doctor will likely advise soaking the labia in warm water (sitz bath) and may prescribe antibiotics and pain medications.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice based on your unique situations, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.