In western medicine, a Bartholin's cyst develops when the duct exiting the Bartholin's gland becomes blocked. The fluid produced by the gland then accumulates, causing the gland to swell and form a cyst. An abscess occurs when a cyst becomes infected. Bartholin's abscesses can be caused by any of a number of bacteria. These include bacterial organisms that cause sexually transmitted diseases such as chlamydia and gonorrhea as well as bacteria normally found in the intestinal tract, such as Escherichia coli. It is common for these abscesses to involve more than one type of organism.

In Chinese medicine, bartholinitis is caused by invasion of pathogen into the greater vestibular gland. In acute bartholinitis, the greater and smaller lips of pudendum on the same side become tumescent and painful. This problem is known as pudendal pain or pudendal swelling in TCM. Under infection, swelling of the gland duct causes adhesion and obstruction which lead to abscess of the greater vestibular gland. After the abatement of acute inflammation, pus is absorbed and develops into cyst known as pudendal cocoon in TCM.

Bartholinitis is usually caused by improper sexual activity, pudendal infection and retention of damp-heat during menstruaton and after delivery and operation as welt as disharmony between qi and blood; or by frequent asthenia of the spleen, dysfunction of the spleen in transformation and transportation, or by transformation of heat from liver depression and downward migration of damp toxin.