- Women's Health
The Bartholin Gland
So what is a Bartholin gland anyhow? Most women do not even know that this gland exists. This is mainly because it remains silent and typically does not cause any problems.
The Bartholin glands (also known as the greater vestibular glands), are located just a smidge below and to the left and right of the vaginal opening in women. They are very small and not visible to the naked eye, however they may be detected as a divot on the skin's surface.
Males have a similar gland. However it is located deeper in the perineal pouch and is called a bulbourethral gland. The Bartholin glands' main function under normal circumstances is to secrete mucus to aid in vaginal lubrication.
Before orgasm, the glands will typically excrete 1-2 drops of mucus to lubricate the vaginal opening, while interior lubrication occurs deeper within the vagina.
Bartholin Glands Will Sometimes Say "Hello"
As stated before, most women go their entire lives without ever realizing that there are two little glands in that area. However, the Bartholin gland can rear its ugly face and make its presence well known.
Although unusual, it can become irritated or infected, causing extreme swelling and discomfort. Typically if the gland(s) do become inflamed and form a cyst, it is usually not painful, only uncomfortable and annoying.
Sometimes, however, a cyst can lead to infection and the area will become even more inflamed. When this happens, the surrounding areas will be tender, warm and may throb if any firm pressure is applied. It can even be almost impossible for one to sit down.
When this happens, the gland is then referred to as a Bartholin cyst that has abscessed.
Bartholin Abscesses: A Painful Experience
If you have ever had the unfortunate chance to experience one of these buggers, then you know all too well just how bothersome and debilitating they can be. In most cases, only one gland is affected at a time. For some unknown reason, the infection can bounce back and forth between glands. (For example, the left one is abscessed then heals and a little while later the right one forms a cyst and abscesses.)
Bartholin cysts form when for some reason the duct exiting the gland become blocked, causing fluid to accumulate. The gland swells, forming a cyst. A Bartholin cyst can lead to an abscess when it becomes infected.
An infection can occur for multiple reasons such as: bacterial infections, sexually transmitted diseases such as chlamydia and gonorrhea, and even some bacteria found in the intestines like e. coli.
Symptoms of a Cyst
- Swelling of labia and surrounding tissue
- Not very much pain associated with it (unless it is large)
Symptoms of an Abscess
- Significant pain near labia and vaginal opening
- Tender to the touch
- Reddish skin covering affected area
- Inability to find any comfy spot
Is It Time for a Doctor?
If at any point you feel that the gland is continuing to swell and grow, and it shows no sign of improvement within 3-4 days, then it’s time to go see your doctor or gynecologist.
If a lump develops and begins to be painful, this is indicative of an abscess and chances are it will not go away on its own. It is an infection, which will get worse without medical intervention. The lump needs to be drained.
Especially if you are experiencing other symptoms such as fever, vomiting, abnormally colored vaginal discharge or abdominal pain (the latter is not a normal symptom), it is time to go to the doctor or ER.
If you are experiencing extreme pain and cannot sit down or wear your normal pants, get to the doctor immediately.
What’s Going to Happen at the Doctors?
There is no testing to confirm a Bartholin cyst or abscess. It is simply diagnosed by a physician through examination. In many cases, especially if the issue is a returning or repeating one, the doctor may collect a culture to determine a bacterial strain so that the best medication can be prescribed. You will also be checked for related STD's such as gonorrhea and chlamydia.
The culture is typically collected from the drainage of the cyst or abscess, and test results are usually back within 48 hrs. When you go to the doctor, you might be given pain killers depending on the severity of your condition.
Once the pain killers have kicked in, a local anesthetic is applied to the affected area, and the doctor will make an incision. The relief is immediate. All the pressure simply goes away. The doctor will then either pack the gland with a special gauze or use a balloon catheter.
As a special note, if it has been decided that the Bartholin gland needs to be lanced, local anesthetics do not work well in areas where there is inflamed tissue. If you are in pain, be sure to discuss your options for relief prior to surgery. You can be sedated if necessary. All you need to do is ask.
Marsupia . . . What?
Occasionally, though no longer as common as it was a few years ago, marsupialization was a procedure that created a permanent drainage site to prevent cyst and/or abscess reoccurrence. The doctor would generously make the recommendation and arrange for a time to do it.
Many doctors today still believe that there is some benefit in performing this procedure in individuals that suffer from this problem on a frequent basis. However it has come to light that this invasive, permanent change may not be as beneficial as once thought.
While marsupialization does provide drainage, it appears that at least 60 percent of those who have had this procedure see reoccurrences. Often the problem jumps to the other gland that has not been marsupialized.
After Surgery Care
Once you have had the cyst or abscess drained, you will probably feel a whole lot better. Proper at home care is imperative to prevent re-infection and sooth any pain or discomfort. If you can spare the money, a shower head with an extendable neck or hose will make regular cleaning much easier and more comfortable as you can adjust the pressure and the wound is not entirely submerged.
Try not to pull on or mess with either the packing or the Word catheter as they can easily become dislodged or fall out. Also, you should opt for the Word catheter if you can since it's less irritating and you can sit down with it, as opposed to the packing, which is excruciating to have removed. If you have packing, take a pain killer prior to removal.
If the catheter falls out within 24 hours, the balloon was not inflated correctly (which often happens) and it needs to be replaced, however if you drop the catheter a few days afterwards you should be alright. Continue using a sitz bath to keep it clean.
Remember that if your doctor prescribed you some antibiotics, you must finish them out. Finish every last pill even if everything feels better. In addition to any medication, ask your doctor for prescription strength ibuprofen or hydrocodone as you will be in pain post surgery for 2-3 days.
Most doctors prescribe clindamycin as the antibiotic in varying doses in accordance with the severity of the infection. If this is the medication you are given, ask for anti-nausea pills because it will make you nauseous.
At Home Prevention
You can help prevent these nasty buggers from coming back. My experience has shown me that when one comes, several follow in a row, generally sticking to one side, or occasionally bouncing back and forth between the right and left sides.
- As mentioned before, regular use of a warm bath will help break up any blockage that may exist or be forming. The occasional addition of Epson salt to a bath increases your ability to prevent a blockage from forming, but be careful that you not overdo it with the Epsom salt as it has the ability to cause dryness, which will lead to chaffing in the genital area.
- Keep strong cleansers and body washes away, instead opting for gentle, fragrance- and dye-free soaps.
- If you feel some swelling coming on, get to a hot bath immediately if you can, and if possible create a current by moving your hands to help move water around the affected area. Repeat this up to 5 times a day with each bath lasting 10 minutes.
- Wear loose fitting pants and non-constricting underwear. During sleep, wear a simple t-shirt to bed or very loose bottoms. Make use of heating pads to sooth and bring comfort as well and encourage the gland to expel the buildup of fluids. Drink a lot of water and fruit juices and stay away from dairy products (dairy increases mucus production) to help flush your system.
- Get plenty of rest to help your body fight the imbalance. If you smoke, try to cut down during this period as it could aggravate the area by increasing the blood flow. Avoid applying pressure to the area as this increases the swelling.
- For at home pain management, try using a cold pack. Don't use an ice pack since in this region of your body solid ice can act very quickly and damage the tissues by freezing them. Stick to gel packs, or in a desperate pinch, take a spoon and place it in the freezer for 15 min, remove it, wrap with a paper towel and apply to the surface of the swollen gland until the spoon is no longer cold or you have achieved some relief.
- Don't overdo it with the cold treatments, which can cause tissue to contract—the opposite of what you want it to do. Heat is your very best friend! Avoid crossing your legs if the swelling is severe, and consider sitting on a pillow instead of harder surfaces such as kitchen chairs which can be aggravating.
While there is little study or research currently about the Bartholin gland, a recent outcry from suffering women is encouraging health care professionals to take a second look at this ongoing condition.
Unfortunately, we still do not know entirely how these little glands work, or why for some individuals they can become chronically infected, swollen, or painful.