Nabothian cysts

Nabothian cysts are a normal cervical finding and do not present a concern unless they are very large. 

Nabothian cysts are also known as mucinous retention cysts or epithelial cysts and are benign features of the adult cervix, with multiple cysts possibly appearing at any given time.

The cysts are similar to blisters, which makes sense: the cysts are due to a blockage in the columnar epithelial cells of the cervix, which produce fertile cervical mucous.

These cervical cells are responsible for an element of fertility – during the fertile phase (ovulation) the cells produce alkaline fertile cervical fluid to allow the easy passage of sperm to the egg. At other times of the menstrual cycle, the mucous is thicker, acting as a sort of blockade, and the vagina is more acidic, which sperm don’t like.

The cysts can be white or yellow, clear, from just millimetres to up to 4cm in diameter.

What causes nabothian cysts?

Nabothian cysts develop because cervical cells have high turnover, meaning they replace themselves quite often. As part of these cells’ normal function, particularly with age, the two different types of cells in the transformation zone of the cervix start to mingle and mix.

The change from columnar epithelial cells to squamous epithelial cells means that a mucous-producing (columnar) cell or cells can get stuck underneath a new non-mucous-producing (squamous) cell, trapping some mucous, which results in a small cyst, or bubble, appearing. This is a Nabothian cyst.

The cyst can lead to some slight inflammation, then tissue repair and a temporary block on the small gland of a columnar cell underneath. This process is normal and tends to resolve itself naturally.

Treatment for nabothian cysts

From time to time, Nabothian cysts may become very large and cause distension of the abdomen as they fill with fluid, and can result in a feeling of discomfort.

If the cysts are larger than 1cm, they should be kept under observation and, if necessary, may need to be either burnt off with liquid nitrogen or cut out. Your physician can advise the best course of action.

Nabothian cysts are considered to be benign and normal for the most part and do not require any treatment. If treatment is required, full healing will occur with the possibility of some scarring, though everything tends to return completely to normal.

To learn about the cervix in more detail, see our comprehensive cervix article.