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Woman Had Labia Cut Open Multiple Times for Bartholin Cysts , Milk weed pod with tiny blue seeds on yellow background

When TikTok user @nothanksalex made a video about how much pain she felt while getting tattooed, she had a warning for her audience: "See, I'm not a super good reference for pain because I have [a] really high pain tolerance: I've had to get my labia cut open 26 times."

This, obviously, led to even more questions, which she answered in a follow-up video. "So, a lot of people are asking why I've had to get my labia cut open a billion times—so I thought I would answer," she joked.

Turns out, she's prone to what are known as Bartholin's cysts. Usually, she said in the video, you can take care of the cysts on your own with a warm compress and they'll drain that way. But since she has had recurring cysts—meaning they come back again and again—she's had to have doctors lance and then drain the cysts so they don't become infected. "It's horrible and nasty and I've gotten it 26 times."

Bartholin's cysts are relatively common—here's what you need to know about them, including common symptoms, treatment options, and possible prevention techniques.

What is a Bartholin’s cyst?

Bartholin's cysts—sometimes known as Bartholin cysts, Bartholin gland cysts, or Bartholin abscesses—occur when a buildup of pus forms a lump in one of the Bartholin's glands, according to Medline Plus, a resource from the US National Library of Medicine. Those glands are found on either side of the vaginal opening, and you usually cant feel them, but you know they're there: Bartholin's glands (and Bartholin's ducts) create and dispense the fluid that moisten the vulva, per the University of Michigan Hospital.

When buildup occurs in one of the glands, it causes the opening of the duct to be blocked, which can lead to an infection, per MedlinePlus. This doesn't necessarily happen overnight: Fluid in one of your Bartholin's glands can build up over the course of many years before the cyst appears. Sometimes, though, it can happen "over several days."

It's not entirely clear why Bartholin's cysts from in the first place, other than due to a buildup of fluid and obstruction of the gland. But experts believe they can become infected by bacteria like E. coli and that which cause sexually transmitted infections like gonorrhea and chlamydia, according to the Mayo Clinic.

What are the symptoms of a Bartholin’s cyst?

You may not even notice a smaller Bartholin's cyst, but if it grows large enough, it can feel like a lump near your vaginal opening, usually only on one side. But if that cyst grows too large or becomes infected, you may feel the following, more intense symptoms, per MedlinePlus:

  • Swelling and redness
  • Pain with sitting or walking
  • Fever (in those with compromised immune systems)
  • Pain with sexual intercourse
  • Vaginal discharge or vaginal pressure

How is a Bartholin’s cyst diagnosed and treated?

A doctor can confirm if you have a Bartholin's cyst by simply doing a pelvic exam, which will reveal whether one of your Bartholin's glands is tender and enlarged. According to the Mayo Clinic, if you're over 40 years old, your doctor may suggest a biopsy: Though rare, a new lump may be a sign of cancer.

Usually, a small, uninfected Bartholin's cyst won't need treatment, but if it's larger or infected, there are certain treatment options—and yes, that could include the surgical drainage of the cyst, through a small incision. After the cyst is drained (while you're under local anesthesia), your doctor may insert a small catheter (aka tube) for drainage to continue as the incision heals.

If having a doctor cut into your vulvar area makes you squeamish, there are other options. According to MedlinePlus, you can help ease discomfort and help the cyst drain on its own by soaking it in a warm water tub four times a day for several days. This, however, may lead to a recurrence, since the opening can close quickly.

If you have recurring Bartholin's cysts, your doctor may suggest one of two more permanent options: marsupialization or excision of the Bartholin's glands.

During the marsupialization procedure, doctors will create an opening along the cyst to let it drain—but instead of closing it back up completely, they'll place stitches at the edges of the cyst. That allows for continual drainage, so more cysts don't occur. With an excision, on the other hand, doctors will completely remove the glands (and the entire cyst wall).

Though there's no real way to prevent Bartholin's cysts, you can help prevent a cyst from becoming infected and turning into an abscess through practicing good hygiene and safe sex.

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