The discovery of a growth during a routine gynecological exam often causes concern, especially for individuals planning a pregnancy. Nabothian cysts are a common finding on the cervix, the lower part of the uterus that connects to the vagina. These small, typically harmless bumps are so frequently observed in adults that they are considered a normal feature. Understanding the nature of these cysts is important to address whether they affect the ability to conceive.
What Exactly is a Nabothian Cyst
A Nabothian cyst is a small, mucus-filled sac that forms on the surface of the cervix. They are entirely benign, non-cancerous growths.
The formation process involves the two main types of cells lining the cervix. The inner cervical canal is lined with mucus-secreting columnar epithelial cells, while the outer portion is covered by stratified squamous epithelium. A Nabothian cyst forms when the stratified squamous epithelium grows over the columnar epithelium, blocking the opening of the Nabothian glands.
The continuous secretion of mucus from the blocked gland causes fluid to accumulate, creating a smooth, rounded bump. These cysts range in size from a few millimeters to approximately four centimeters in diameter. They are common, particularly in women who have given birth, as the healing process after childbirth can accelerate this tissue overgrowth. Chronic inflammation of the cervix, known as cervicitis, can also lead to their development.
The Direct Impact on Fertility and Conception
For the vast majority of women, a diagnosis of a Nabothian cyst has no bearing on their ability to get pregnant. Medical professionals agree that these cysts do not interfere with the reproductive process. This is primarily because they are superficial growths that do not obstruct the cervical canal, which is the pathway for sperm to travel into the uterus.
The cervical canal is the pathway for sperm to travel from the vagina into the uterus. Sperm must pass through the cervical os, and since the cyst is usually located on the outer surface, this central passage remains clear. Therefore, the cyst does not impede sperm passage, fertilization, or subsequent implantation.
Nabothian cysts are often discovered incidentally during routine pelvic examinations or during a fertility workup for other reasons.
However, extremely rare instances exist where the size and location of the cysts might introduce a complication. Giant Nabothian cysts, exceeding four centimeters, or multiple very large cysts can potentially obstruct the cervical canal. This physical blockage could make it more difficult for sperm to pass or interfere with the quality of cervical mucus, which is important for sperm transport. For women experiencing unexplained infertility, particularly if large cysts are present, the removal of the obstruction may precede conception.
When to Consult a Doctor About Cervical Cysts
While most Nabothian cysts require no treatment, consulting a healthcare provider for a thorough examination is important. The primary reason for a consultation is to ensure a correct differential diagnosis. A doctor must confirm the growth is a benign Nabothian cyst and not a different, more concerning cervical lesion, such as a cervical polyp or a malignant tumor.
A physician may recommend further investigation if the cyst presents with unusual characteristics, such as a solid component or an atypical appearance on imaging. Although Nabothian cysts are generally asymptomatic, a consultation is warranted if you experience unusual vaginal bleeding between periods, a persistent discharge, or pelvic pain. These symptoms could indicate an underlying issue, such as an infection, requiring separate treatment.
In rare instances, numerous or large cysts can distort the shape of the cervix or interfere with routine screening procedures. For example, a very large cyst can obscure the cervix, making a Pap test difficult to complete accurately. If a cyst causes discomfort, pain during intercourse, or interferes with necessary screening, a doctor may suggest a simple in-office procedure to drain or remove it.