The cervix is the lower, narrow part of the uterus that connects the main body of the uterus to the vagina. Nabothian cysts are common, appearing as small, smooth bumps on the cervical surface. These growths are classified as benign, meaning they are non-cancerous. They are a frequent occurrence in individuals of reproductive age and typically require no medical intervention.
How Nabothian Cysts Form
The cervix is lined by two distinct types of tissue: the mucus-producing columnar epithelium lining the inside of the cervical canal, and the protective squamous epithelium covering the outer surface. The area where these two cell types meet is known as the transformation zone. This dynamic region shifts location over a person’s lifetime and is where the physiological change of one cell type being replaced by another, known as metaplasia, frequently occurs.
Nabothian cysts form when the squamous epithelium grows and spreads, covering the openings of the mucus-secreting endocervical glands. This overgrowth traps the mucus continuously produced by the underlying columnar cells. As the mucus has nowhere to escape, it accumulates and causes the gland to swell, forming a retention cyst.
This process of tissue remodeling is often triggered by natural events such as childbirth, where the cervix undergoes significant healing and new tissue growth. Chronic inflammation or minor trauma to the cervical tissue can also initiate the epithelial overgrowth leading to glandular blockage. The trapped mucus inside the cyst is usually a clear or pale yellow fluid and can cause the cysts to vary in size, though they are often only a few millimeters in diameter.
Symptoms and Clinical Significance
For the vast majority of people, Nabothian cysts are completely asymptomatic and pose no health risk. They do not typically cause symptoms such as pelvic pain, abnormal bleeding, or unusual discharge. Since they are mucus-filled retention cysts, their presence does not increase the risk of developing cervical cancer or any other serious gynecological condition.
The cysts are generally small, often measuring between two and ten millimeters, which is why they usually go unnoticed. Nabothian cysts do not interfere with fertility or a person’s ability to conceive or carry a pregnancy. Their minimal clinical significance means they are usually discovered incidentally during routine gynecological screenings or imaging performed for unrelated reasons.
In rare instances, a cyst may grow larger than one centimeter or multiple cysts may cluster together, potentially causing a minor feeling of pressure or fullness in the pelvic area. Even in these uncommon cases, the primary concern is not the cyst itself but the possibility that it might interfere with a medical examination. Most Nabothian cysts remain small and static, requiring no further attention once their benign nature is confirmed.
Diagnosis and Management
Nabothian cysts are most frequently identified during a standard pelvic examination using a speculum, where they appear as smooth, white, or yellowish raised bumps on the cervical surface. A healthcare provider can often make a presumptive diagnosis based on their characteristic appearance alone. If the diagnosis is unclear or the cyst presents atypically, a colposcopy may be performed, which uses a specialized magnifying instrument to get a detailed, illuminated view of the cervix.
Colposcopy is useful for distinguishing Nabothian cysts from other, more serious lesions that can sometimes resemble them, such as a rare form of cervical cancer called adenoma malignum. Transvaginal ultrasound or magnetic resonance imaging (MRI) may be utilized to confirm the fluid-filled nature of the lesion and map its exact location and size. These imaging techniques can provide assurance that the growth is not solid or concerning.
Since these cysts are benign and typically asymptomatic, the standard management approach is “watchful waiting,” meaning no active treatment is required. The cysts are monitored during routine check-ups. Intervention is only considered if the cyst is so large that it physically obstructs the view of the transformation zone during a necessary screening procedure, such as a Pap smear or colposcopy.
If a cyst must be addressed, simple procedures are available to resolve the blockage and allow for proper examination. This may involve puncturing the cyst to drain the trapped mucus, a technique known as fenestration or simple drainage. Alternatively, electrocautery or cryotherapy might be used to destroy the cyst wall, which prevents the gland from blocking again. These interventions are primarily performed to restore clear visibility of the cervix for cancer screening, not because the cyst itself poses a direct health threat.