Nabothian cysts are common, usually harmless bumps found on the cervix. Their discovery often causes anxiety, particularly for those trying to conceive, raising questions about potential interference with reproductive health. Understanding the nature of these cysts is key to separating common findings from actual medical concerns.
Understanding Nabothian Cysts
A Nabothian cyst is a small, mucus-filled bump that develops on the surface of the cervix, the lower part of the uterus. They are considered benign, meaning they are non-cancerous.
The formation of these cysts involves the mucus-producing glands in the cervix. When the opening of a gland becomes covered by an overgrowth of skin cells, the mucus gets trapped inside. As the mucus accumulates, it forms a smooth, dome-shaped cyst that can range from a few millimeters to a few centimeters in size.
This tissue remodeling frequently occurs after childbirth, minor trauma, or chronic inflammation of the cervix (cervicitis). Because they result from a natural healing process, these cysts are common in people of childbearing age and those who have given birth.
The Direct Link to Fertility
The core question is whether Nabothian cysts can cause infertility, and the answer is generally no. For the vast majority of people, these cysts pose no barrier to conception or pregnancy. They typically form on the external surface of the cervix and do not obstruct the cervical canal, the pathway for sperm to travel into the uterus.
Small or medium-sized cysts do not physically block the sperm’s route. Nabothian cysts also do not interfere with reproductive hormones or the ability of a fertilized egg to implant in the uterine lining. Their presence is a normal, incidental finding that does not impact reproductive function.
However, extremely rare instances exist where multiple cysts or a single, unusually large, “giant” cyst may cause a mechanical obstruction of the cervical canal. In these exceptional cases, the volume of the cysts may narrow the passage enough to potentially impede sperm movement. Case reports documenting this scenario are uncommon, and the cyst is often not the sole cause of infertility.
Diagnosis and Monitoring
Nabothian cysts are most frequently discovered incidentally during routine gynecological examinations, such as a standard pelvic exam or a Pap smear. Since they are typically asymptomatic, most people are unaware they have them until a health care provider points them out. The cysts appear as smooth, small, white or yellow bumps on the cervical surface.
To confirm the diagnosis, a physician may use a colposcopy, a magnified visual examination of the cervix, to differentiate the bumps from other possible abnormalities. Imaging techniques like transvaginal ultrasound or MRI may also be utilized to confirm the fluid-filled nature of the structure. These techniques help rule out more serious conditions that can mimic the cysts, such as adenoma malignum.
Because of their benign nature, the standard approach once a Nabothian cyst is confirmed is observation and monitoring. No immediate action is required for small, asymptomatic cysts. Regular check-ups are sufficient to ensure the cysts do not change in size or cause new symptoms.
When Treatment is Necessary
Treatment for Nabothian cysts is the exception rather than the rule, as the cysts usually resolve on their own or remain harmlessly in place. Intervention is considered only in specific, rare circumstances where the cysts become problematic.
One primary reason for treatment is if the cysts obscure the cervix, making it difficult to perform necessary diagnostic procedures like a Pap smear or colposcopy. Treatment may also be necessary if a giant cyst causes symptoms like pelvic discomfort or unusual bleeding, or in the rare case of proven cervical obstruction linked to infertility.
Simple treatment methods are available and often performed in an outpatient setting. Procedures include electrocautery, which uses an electrical current to destroy the cyst, or cryotherapy, which involves freezing the cyst. A physician may also opt for simple drainage by puncturing the cyst to release the trapped mucus.