Nabothian cysts are small, benign bumps that form on the surface of the cervix when mucus-secreting glands become blocked. They are extremely common, especially in women of reproductive age and those who have given birth. In the vast majority of cases, they cause no symptoms, require no treatment, and are not a sign of anything dangerous.
How Nabothian Cysts Form
Your cervix contains tiny glands that produce mucus. These glands are lined with a type of tissue called columnar epithelium. Sometimes, a different type of tissue, flat squamous epithelium, grows over the top of these glands and traps the mucus inside. With nowhere to drain, the mucus accumulates and forms a small, fluid-filled cyst.
This overgrowth of tissue happens through a process called squamous metaplasia, which is a normal part of how the cervix changes over time. It occurs naturally in an area of the cervix known as the transformation zone, where the two types of tissue meet. While it can happen on its own as part of normal cervical biology, several things speed it up or make it more likely:
- Childbirth: The physical trauma of delivery triggers healing and tissue changes on the cervix, making nabothian cysts very common in women who have given birth.
- Chronic cervicitis: Ongoing inflammation of the cervix, from infection or irritation, promotes the same kind of tissue overgrowth.
- Cervical procedures: Treatments like cauterization or cryotherapy (freezing) can cause the squamous tissue to grow over gland openings during healing.
- General trauma: Any injury to the cervix can set off the same process.
What They Look and Feel Like
Most nabothian cysts are small, typically a few millimeters across, though they can occasionally grow up to 4 cm. They appear as smooth, round, well-defined bumps on the cervix. They can be single or multiple. A doctor usually spots them during a routine pelvic exam or Pap smear, and they often look whitish or yellowish, filled with thick, jellylike mucus.
Most women never know they have them. The cysts don’t cause pain, bleeding, or discharge on their own. You can’t feel them, and they don’t interfere with daily life.
When Large Cysts Cause Symptoms
In rare cases, nabothian cysts grow large enough to press on surrounding structures. When this happens, symptoms can include abdominal or pelvic pain, a feeling of pelvic pressure or congestion, painful intercourse, or vaginal bleeding. Very large cysts can even compress the rectum and cause changes in bowel habits. Some women with large or inflamed cysts notice increased watery or thick yellowish discharge. These situations are uncommon, and the vast majority of nabothian cysts never reach a size where they cause problems.
How They Are Diagnosed
Nabothian cysts are usually discovered incidentally during a routine pelvic exam, where they’re visible to the naked eye on the cervix. If a cyst looks typical (small, round, smooth borders, no solid areas inside), no further testing is needed. When there’s any uncertainty about what a growth is, a doctor may use a colposcope, a magnifying instrument, to get a closer look. Transvaginal ultrasound can also help characterize the cyst, showing its fluid-filled nature and well-defined edges.
Telling Them Apart From Something Serious
One reason doctors pay attention to cervical cysts is to make sure they aren’t something else. A very rare type of cervical cancer called adenoma malignum can sometimes look cystic on imaging. The key differences are clear. Benign nabothian cysts are small, have well-defined margins, contain only fluid (no solid components), and sit near the surface of the cervix. A malignant cystic lesion tends to invade deeper into cervical tissue, may contain solid areas, and is more likely to be associated with large amounts of watery discharge or other masses.
If your doctor tells you that you have a nabothian cyst based on a standard exam, the chance it’s anything else is extremely low. Further workup with imaging or biopsy is only considered when a cyst is unusually large, deep, or has atypical features.
Do They Affect Fertility or Pregnancy?
Standard nabothian cysts do not affect your ability to get pregnant. There is some speculation in the medical literature that very large or numerous cysts could theoretically interfere with fertility by physically blocking the cervical canal or altering mucus production that sperm need to travel through. However, this link remains unproven. Some case reports describe women conceiving after large cysts were removed, but no study has established that the cysts themselves were the cause of difficulty conceiving.
For women undergoing fertility treatments like embryo transfer, large cervical cysts could complicate the procedure by getting in the way of catheter placement. In these specific situations, a doctor might recommend removing the cyst before proceeding. Outside of that narrow scenario, nabothian cysts are not considered a fertility concern.
Treatment and Removal
Most nabothian cysts need no treatment at all. They are benign, stable, and often stay the same size for years. Many doctors won’t even mention them because they’re considered a normal finding, not a medical problem.
Removal is only considered when a cyst is large enough to cause symptoms like pain, pressure, or discharge, or when there’s diagnostic uncertainty. The two most common removal methods are electrocautery (using heat to open and drain the cyst) and cryotherapy (using cold). Both are quick outpatient procedures. Recovery from draining a small cyst typically takes a few days to a couple of weeks. Larger cysts that require a bigger incision may take several weeks to fully heal. Some mild pain and swelling afterward is normal.
One thing to be aware of: cysts that are simply drained without removing the lining of the sac can refill over time. Complete removal of the cyst wall reduces the chance of recurrence. Complications like infection, bleeding, or scarring are possible but uncommon.