Bartholin Cyst – Ayurvedic Aspect and Herbal Treatment

ABSTRACT

Bartholin glands are pea -sized glands  located on each side of the vaginal opening. When these glands get blocked lead to Bartholin cyst . These  are the commonest  types of vulvar masses  that are asymptomatic  in starting  but if not treated , they  can get infected and become large masses . Initially they  are painless and  mildly tender . Physical examination, investigation of samples of secretions or biopsy is done to make diagnosis.Herbal remedies  are helpful in managing this condition .

INTRODUCTION

It is a common condition that occurs in females. When there is fluid accumulation in bartholin glands, it leads to their blockage . They are always benign or non-cancerous  in nature. They may be asymptomatic or produce few symptoms.Treatment  is based on the size of the cyst and whether it is infected or painful. It can be managed at home with  herbal and home remedies. Sometimes surgical management is required.

AYURVEDIC ASPECT

According to Ayurveda It can be compared with the ‘YONIKANDA ‘condition in which’ yoni’  means vagina and’ Kanda’ means tuber-like growth or protuberant mass . It is described in Madhava nidana , bhavaprakasha  and Sharangdhar samhita.

Causes and pathogenesis of yonikanda  are –

1. Day-sleeping ( Diwaswapana)
2. Excessive angerness ( ati krodh )
3. Excessive exercise and coitus ( Ativyayama atimaithunaat)
4. Ulceration by nail, teeth or thorns ( khatat nakha danta adibah)

Due to these causative factors , doshas get aggravated as per their respective causes and produce a protuberant structure (kanda) resembling round in shape (nikuch akriti)  or like irregular shaped fruit (lakuch) . Its color resembles the color of pus or blood (puya shonit sankasha). This condition is known as Yonikanda or yonija kanda .

Types of Yoni Khanda

It is of 4 types-

1. Vataja yonikanda – There is vitiation of vata dosha
2. Pittaja yonikanda – Due to vitiated pitta dosha
3. Kaphaja yoni khanda – Kapha dosha is increased in body
4. Sannipataja yonikanda – There is an imbalance of three doshas.

Clinical Features of Yonikanda

1. Vataja Yonikanda– Vaginal protuberance that is  dry, rough, discolored and cracked in appearance is known as vataja yonikanda.
2. Pittaja Yonikanda- Vaginal protuberance that is associated with burning sensation, redness and fever is present in pittaja yonikanda.
3. Kaphaja Yoni Khanda- Vaginal protuberance that resembles the color of flower atasi or flax ( bluish ) and is associated with itching is known as kaphaja yoni khanda .
4. Sannipataja Yonikanda- Vaginal protuberance that is associated with clinical features of tridoshas is known as sannipataja yonikanda.

TREATMENT OF  YONIKANDA 

1. Yonipurana ( vagina filling ) :- yonipurna means filling of vagina with powder of red ochre(gairik), kernel of mango(amrasthi), jantana , rajani, anjana and katphala.
2. Vaginal irrigation:- vaginal irrigation is done with decoction of triphala mixed with honey .
3. Mushika taila Tampon :- Oil is prepared by boiling with small pieces of rat and when the meat is properly cooked , oil is filtered and tampon soaked in this oil is kept in vagina.

SYMPTOMS

Bartholin cyst is asymptomatic in starting , but if get infected  can turn into Bartholin abscess.

Non-infected bartholin cyst has  following features:

• Presence of lump in vulvar region near vaginal opening.
• It is painless but in some cases tenderness is present

Whereas Bartholin abscess has following features:

• Severe pain may be present
• Discomfort  while walking and sitting
• Discomfort during sexual intercourse(dyspareunia)
• Fever
• On touching it is warm and soft.
• Fluctuant mass in lower medial labia majora
• -vaginal discharge

CAUSES

• The exact cause is not known behind blockage of bartholin  glands.
• It is believed that fluid gets accumulated in bartholin glands and it is associated with blockage of bartholin duct.
• Infected  bartholin’s cyst or bartholin abscess  infection can be caused by :- Escherichia coli (E. coli).
• 1 in five women are believed to have bartholin’s cyst in life at some point.It usually occurs in the age of 20s.With increasing age its chances of occurrence decreases.

COMPLICATIONS

 Bartholin cyst usually treatable but if left untreated it can lead to following  complications :-

1. Bartholin abscess
2. Bartholin giant cyst
3. Septicemia ( if infection spread to whole body through infection)

DIAGNOSIS

Diagnosis of Bartholin ‘s cyst is made on the basis of :-

1. Proper medical history
2. Local pelvic examination- To check warmness, softness , tenderness, fluctuation.
3. Secretion sampling from vagina and cervix for testing of sexually transmitted infection.
4. Biopsy :- if woman is above 40 years of age or postmenopausal.
5. Magnetic resonance imaging (MRI scan) :- In case of giant bartholin’s cyst.

HERBAL REMEDIES

There  are some herbal remedies from the house of planet Ayurveda  that are helpful in managing Bartholin’s cyst . It includes  following herbal formulations.

1. Gandhak Rasayan

Gandhak is  purified sulphur  and good quality   sulphur is used in making  tablets of gandhak rasayan. It is helpful in balancing all three doshas ( body energies) of the body. It is used in treating various skin diseases such as itching, fungal infections.

Dose- 1 to 2 tablets twice daily with plain water after meals.

2. Kanchnaar Guggul

Kanchnaar ( Bauhinia variegata)and guggul (Commiphora mukul)  are the main active  ingredients along with other herbs that are used in preparation of this formulation. It has anti-nodular, anti-inflammatory properties helpful in treating various kinds of growths , cysts, thyroid disorders in the body.

Dose- 2 tablets twice daily with plain water after meals.

3. Female Health Support

It is a wonderful remedy from the house of planet Ayurveda . This  formulation contains three herbs that are having properties of  supporting whole female  health –Ashoka, Lodhra and shatavari. It helps in balancing vitiated vata and pitta dosha.It is beneficial in all problems related to the female reproductive system.

4. Planet Rose Soap

Rose soap by planet ayurveda is helpful in cleansing  the affected area. It maintains the  outer skin surface and provides smoothness and nourishment.

How to use- Use locally over the affected area.

5. Sphatika Bhasm and Arjun Saar

Affected part should  be rinsed with a mixture of arjun saar (3 spoons) and sphatika bhasma (1/4 spoon) in 1 mug of water. It helps in  decreasing discomfort and promotes effective drainage of the gland.

HOME REMEDIES

Bartholin’s cyst can be easily managed at home if it is non –infected , even infected  one can also be treated.Here are some home remedies that can be helpful in it are :-

1) Sitz bath  – Sit in tub filled with warm water upto few inches , four times  a day for 5 to 7 days helps in resolving  infected and non-infected bartholin’s cyst.It is also beneficial even after surgical procedure to  maintain cleanliness, effective drainage of gland and  to relieve discomfort.

2) Hot compress – Simple hot compression over the bartholin’s cyst  is the easiest home remedy  helpful in  efficient drainage and shrinking of the cysts.

3) Aloe vera is helpful in relieving discomfort, swelling in  bartholin cyst . It can be applied locally over the affected area.

4) Apple cider vinegar is the good agent for rinsing , washing  the affected area of bartholin cyst. It prevents infection.

DIET AND LIFESTYLE CHANGES

A balanced diet is always  beneficial in maintaining a healthy body and life. Diet and lifestyle these days are the root cause of many problems. So, if we follow a diet and lifestyle many diseased conditions can be prevented. Mild illnesses can be managed by just changing diet and lifestyle without taking any medicine.

Healthy Diet should Include :-

1) Drink  at least 2-3 litres water per day to stay hydrated.

2) Fresh fruits should be included in a diet such as apples, mangoes, bananas, papaya, pear, figs.

3) Avoid citrus fruits like oranges, lemon, berries, and grapefruit are not good in cystic conditions.

4) Always eat freshly cooked or steamed vegetables such as broccoli, beans, cabbage, cauliflower, tomatoes,garlic, onion,peas, potatoes etc.And always avoid eating raw vegetables, salads and overcooked food.

5) You can also consume nuts, dry fruits , and seeds  except  cashew nuts.

6) Lean meat  including chicken, salmon fish and sardines are good in cysts but avoid intake of red , dark poultry meat.

7) Only low fat dairy products should be consumed.

8) Avoid eating pickles and refined oil , whereas olive oil, almond oil and desi ghee is good for health.

9) Avoid bakery products, junk food, processed and packed foods.

Lifestyles changes include:-

1. Always maintain  a healthy body weight.
2. Do regular exercise and include walking, yoga, meditation in your daily routine.
3. Stop smoking, tobacco intake and limit the alcohol intake.
4. Avoid sleeping in the daytime and make a habit of waking up early in the morning and sleeping on time in the night
5. Always indulge in safe and protective coitus by use of condoms and other protective measures.
6. Always try to stay calm, happy and stress free.
7. Proper hygiene should be maintained. Hygiene is a key point to avoid any kind of infection.

OTHER PRECAUTIONS TO BE TAKEN 

Following measures can be helpful in decreasing the risk of getting bartholin’s cyst or to prevent further infection –

1. Hygiene should be maintained in the local area as well as the whole
2. Avoid overindulgence in the coitus.
3. Screening should be done for Sexually transmitted diseases.
4. Always wash the private parts after peeing, coitus. Avoid using public washrooms.
5. After the age of 40 women should be screened for cancer. Try to visit your doctor for routine checkups.

CONCLUSION

Bartholin cyst is the common condition in females  which is usually asymptomatic . It is an easily manageable condition at home with simple home and herbal remedies having wonderful results . Proper hygiene measures and prevention can help in preventing it but its exact cause is not known yet.

FAQ’S 

1.Can Bartholin’s cyst resolve on its own?

Many bartholin’s cysts can resolve themselves even if it is infected , after 3 to 4 days without any treatment. But care should be taken when cyst is healing , avoid  coitus at that time. Usually it’s asymptomatic but if it is painful, consult a doctor.

2.What are the causes of Bartholin’s cyst ?

Exact cause of Bartholin’s cyst is not known , Duct of bartholin cyst  gets blocked by infection, thick mucus etc due to which fluid accumulates in the gland. Rarely cysts can occur due to Sexually transmitted infections.

3.Is Bartholin cyst cancerous ?

Bartholin’s cyst is almost always benign in nature, that means non-cancerous. They are just fluid filled glands, appearing as swelling known as cyst.

4.Can shaving of a private part cause  Bartholin’s cyst ?

Shaving or waxing hairs from the pubic area can cause irritation , plucking of hair follicles which can lead to infection.A painful bump starts as a small swelling and grows into a larger boil. If the cyst gets infected it can turn into boiling which is extremely painful in nature.

5.Is it dangerous to squeeze a bartholin cyst?

Do not squeeze bartholin cyst at home as  it can get infected and may turn into bartholin abscess or  giant bartholin cyst. It should always be drained by giving small incisions over the gland under septic conditions.

6.What contains bartholin’s cyst?

Bartholin’s cyst is bartholin’s gland filled with liquid or semisolid content. Bartholin’s gland release a fluid physiologically which is lubricating in nature .Due to some reason when duct of bartholin gland gets blocked , the fluid gets collected in the gland  which is known as bartholin’s cyst and when get infected can cause pus formation and pain.

7. Can bartholin’s cyst dissolve naturally?

Yes there are some herbal remedies that help in dissolving bartholin cyst  in a natural way. It includes sitz bath, hot compress, rinsing with apple cider vinegar, local application of honey and aloe vera. But if it is painful and hampering daily life activities, growing rapidly , then you should consult a doctor.

REFERENCE

1. Madhav nidana
2. Bhav prakash