Vulval lumps and bumps can be disconcerting, but try not to worry!
Medically reviewed by Dr Juliet McGrattan (MBChB) and words by Paisley Gilmour
Concerned about a soft lump near or inside your vagina? Finding a lump anywhere on your body can be disconcerting, but try not to worry. Vaginal cysts are a common type of vaginal lump and they’re usually harmless. There are several types of vaginal cysts and they don’t usually cause any symptoms. They can sometimes become painful or infected, in which case they need medical treatment.
We spoke to Dr Shirin Lakhani from Elite Aesthetics and Dr Deborah Lee, sexual and reproductive healthcare specialist at Dr Fox Online Pharmacy about vaginal cyst symptoms, types, treatment and surgery options:
What is a vaginal cyst?
Vaginal cysts are sac-like pockets of air, fluid, or pus located on or just under the vaginal lining and while they sound ominous, they’re usually nothing to worry about. ‘Vaginal cysts are just another type of growth that people get’, says Dr Lakhani.
Vaginal cysts can be present from birth, or develop in childhood or adulthood. The good news is vaginal cysts are benign, non-cancerous and rare, with a prevalence of less than 1 per cent. Whether or not your cyst develops into a larger growth or remains undetected is largely luck of the drawer. ‘Some are so small you can hardly see them and some can grow to the size of a tennis ball,’ says Dr Lakhani.
Vaginal cyst symptoms
Most people will not experience any symptoms if they have a vaginal cyst. You might discover a cyst by chance. It might also be something that a doctor or nurse spots when examining you for another reason such as during a cervical screening (smear) test.
Vaginal cysts can however cause any of the following symptoms:
- Discomfort or difficulty inserting a tampon.
- Discomfort when having sex.
- A feeling of pressure or fullness from a large cyst.
- Pain if a cyst has become infected.
Should you see your doctor about a vaginal cyst?
If you suspect you have a vaginal cyst or are experiencing any pain or discomfort in your vaginal area, make an appointment with your GP so that it can be investigated.
Your doctor will ask you how long the cyst has been present and whether it is causing any symptoms. They may also ask whether you have had any changes in your menstrual cycle, any unusual discharge or bleeding and whether you have had any new sexual partners. ‘Your doctor or specialist will usually carry out an examination to ascertain what type of cyst it is,’ says Dr Lakhani.
If you suspect you have a vaginal cyst or experience any discomfort, make an appointment with your GP.
If the cyst is on the outside, then an external examination may be sufficient. However, if the cyst is inside the vagina, a device called a speculum may be inserted into the vagina to open up the tissues slightly and give a clear view of the vaginal walls. This type of examination should not cause pain but can sometimes feel a little uncomfortable, especially if you feel nervous and tense. Be sure to let the doctor know how you are feeling.
The doctor or nurse may take some swabs to check for vaginal infections. If they are unsure about the diagnosis they will refer you to a specialist who has further access to tests such as scans or biopsies where a small sample of the cyst tissue is taken and looked at under the microscope to reach a diagnosis.
Vaginal cysts types and causes
There are several types of vaginal cysts and they can be caused by a number of factors including injury during childbirth, fluid buildup in the glands of the vaginal and vulval tissues, or benign (non-cancerous) tumours within the vagina, according to Dr Lakhani.
While vaginal cysts are nothing to worry about, finding a lump anywhere on your body can be disconcerting so if you’re not sure, make an appointment with your GP.
The following are the most common types of vaginal cysts and their specific causes:
- Vaginal inclusion cysts
Vaginal inclusion cysts are the most common type of vaginal cysts, they can result from injuries sustained in childbirth. They are usually very small so you might not even notice if you have them.
- Gartner duct cysts
Gartner’s duct cysts are benign lesions that are found in about 25 per cent of adult women and sometimes develop into a cyst. ‘These are due to the embryonic remnants of Gartner’s duct when your body was formed in utero,’ says Dr Lee.
- Bartholin’s cysts
The Bartholin’s glands, of which you have two, are found on each side, towards the posterior aspect of the vagina, inside the labia (lips of the vulva). ‘Normally you are unaware of this, however, sometimes one of your Bartholin’s glands may fill up with fluid, and this fails to discharge leaving a fluid-filled cyst,’ says Dr Lee. ‘This can become infected to produce a Bartholin’s abscess. ‘ Different types of bacteria can cause a Bartholin’s abscess including E.Coli from the bowel and also STIs, notably gonorrhoea.’
- Mullerian cysts
Mullerian cysts are another common type of vaginal cyst that result from embryonic remnants. They can develop ‘when your body was formed in utero and can occur anywhere in the vaginal walls,’ says Dr Lee.
- Soft tissue lumps
Any soft tissue lumps which occur anywhere in the body can also be present in the vagina, ‘for example, lipomas or fatty lumps, and sebaceous cysts,’ says Dr Lee. ‘Vaginal cancers can present as lumps in the vagina, but these are not usually cysts,’
Vaginal cyst risk factors
The age group most at risk of vaginal cysts are sexually active women aged between 20 and 30. Cysts are also less common in post-menopausal women. Dr Lakhani explains this is because ‘by then the gland has started to shrink’.
Children are not typically at risk of vaginal cysts. ‘As the Bartholin’s glands don’t start working until a person hits puberty, Bartholin’s cysts don’t usually affect children,’ Dr Lakhani adds.
Can you reduce the risk of vaginal cysts? ‘While I’m not aware of any research directly linking vaginal cysts with lifestyle factors such as smoking and drinking alcohol, it goes without saying that an overall healthy diet and lifestyle is always beneficial when trying to avoid health complications,’ adds Dr Lakhani. ‘So ensuring you try to eat a healthy balanced diet and aren’t overweight will also be advisable in order to try and reduce your risk.’
Vaginal cyst treatment and surgery
Vaginal cyst treatment options vary depending on the type of cyst you have. ‘Sometimes the doctor will decide to keep an eye on a cyst and see if it gets bigger or disappears by itself. Other times, they may decide it should be surgically removed,’ says Dr Lee.
‘If it’s an abscess, which is usually painful, then you’ll likely be prescribed antibiotics to address the infection. After it’s been treated you’ll probably need a follow-up appointment and in some cases the cyst will need to be drained.’
Sometimes the doctor will decide to keep an eye on a cyst and see if it gets bigger or disappears by itself.
An infected cyst such as a Bartholin’s abscess is likely to require treatment including incision and drainage. ‘For Bartholin’s gland cysts, the specialist may recommend surgery to remove the affected gland. This is usually done under general anaesthetic and carries the usual risks associated with surgery,’ Dr Lakhani explains.
‘Carbon dioxide lasers can be used to create an opening in the skin of the vulva so that the cyst can be drained. Alternatively, needle aspiration involves using a syringe to drain the cyst.’ Lee adds that if you remove a cyst, there is ‘a small risk as there always is with surgery, of infection, and scarring.’
Vaginal cyst prevention
Can you deter vaginal cysts from developing? It’s virtually impossible to prevent a vaginal cyst growing, according to Dr Lakhani. However she does suggest some lifestyle tips that may reduce the chance of getting one. ‘These include keeping the vagina clean and practising safe sex, to eliminate the chance of catching a sexually transmitted infection.’
Dr Lee adds that if you experience a Bartholin’s cysts and receive treatment for it, the way in which they are treated prevents them from reforming. ‘After incision, the skin flaps are sewn diagonally using a technique called marsupialisation to prevent recurrence,’ she says.
Vaginal cyst complications
Complications or long-term health effects due to vaginal cysts are rare. ‘The main long-term effects of cysts are the pain and discomfort they cause and the impact this has on a person’s physical and mental health, as well as their ability to enjoy sex,’ Dr Lakhani explains. ‘Sometimes they can become infected – but this isn’t common.’
If you leave a cyst untreated, there is a risk that it can get bigger over time, says Dr Lee. This may become uncomfortable ‘as it stretches the skin and presses on other tissues,’ she adds.