Nabothian Cyst (Cyst of Naboth) – Everything You Need to Know About Causes, Symptoms & Treatment

Also known as a cervical cyst, epithelial cyst or mucous retention cyst, the Nabothian cyst is usually symptomless and harmless, with no medical significance whatsoever. Doctors typically discover one only by chance during a gynaecological examination, appearing as a small bump on the cervix.

There are, however, situations in which a cyst needs to be removed because it may cause complications. On this page you'll find out what those situations are, along with everything else you should know about Nabothian cysts.

 What is a Nabothian cyst

A Nabothian cyst is a benign gynaecological change on the cervix that appears as a small, mucus-filled bump – the mucus being produced by the cervical glands.

Picture your cervix as a delicate surface surrounded by glands and cells that produce mucus quite normally. These glands can become covered and sealed over by a type of epithelial cell – at which point they fill up and become blocked with secretions. The fluid then collects in small bumps that look like white spots and are known as Nabothian cysts.

A patient may have a single Nabothian cyst or several. Such cysts generally pose no threat, they're not dangerous and they're not a sign of cervical cancer. If they cause no symptoms or complications, they can simply be left alone.

There are cases, however, where a doctor will recommend removal – for instance if they're too large and obstruct the view of the cervix during an examination.

 Who gets Nabothian cysts

Women are affected – essentially anyone with a cervix can develop this type of cyst. They occur quite naturally, particularly during puberty and the menopause, but there are also certain situations or life stages that affect how the cervical glands function. You're more prone to blocked glands and the formation of Nabothian cysts after:

• giving birth: following pregnancy, epithelial cells grow more rapidly, and the new cells can block the glands and thereby lead to the formation of Nabothian cysts.
• an injury to the cervical area: epithelial cells also multiply after an injury to the cervix in order to help the tissue heal. In doing so they can likewise block the glands, trapping the secretions inside and forming Nabothian cysts.
• inflammation or infection of the cervix: as with injuries, the cells multiply to heal wounds or damage caused by cervical inflammation or infection. Their job is to support regeneration after conditions such as chronic cervicitis – but at the same time they can block the glands and lead to the formation of a Nabothian cyst.

How common are Nabothian cysts

Nabothian cysts are among the most common findings gynaecologists come across during examinations – and they require no treatment at all.

They're simply an altered appearance of the cervix, to which pregnant women, girls going through puberty and women in the menopause are especially prone, but which does your body no harm whatsoever.

 Causes of Nabothian cysts

As explained above, your cervix is surrounded by cells and glands that naturally and continuously produce mucus.

Sometimes (particularly in the cases mentioned above, i.e. after pregnancy, an injury or inflammation of the cervix), healthy epithelial cells cover these glands in order to repair the cervical tissue.

The problem is that by covering the glands, they trap the mucus inside, and the secretions can no longer drain away. Sealed within the cervical glands, the mucus builds up and forms a Nabothian cyst – which is, however, completely harmless to you.

Risk factors for Nabothian cysts

Any woman can develop Nabothian cysts – at any time from puberty right through to the menopause, so roughly between the ages of 40 and 50. Pregnant women make up another at-risk group for this change.

Another situation in which you may be susceptible to cyst-like changes is what's known as adenoma malignum, which affects mucus production in the cervix and gives rise to cysts that look remarkably similar to Nabothian cysts.

 Nabothian cysts – symptoms

A Nabothian cyst may be white or yellowish, with clear or indistinct borders, and depending on how much mucus is trapped inside, it can measure anything from a few millimetres to 4 cm across.

Aside from their unusual appearance, these cysts generally cause no other symptoms. They're not painful and they don't interfere with your daily life. You may not even know you have them until your gynaecologist mentions it during a routine check-up.

Very occasionally, a Nabothian cyst may cause discomfort, such as a feeling of pressure in the vaginal area or pain before, during or after intercourse.

Visible symptoms may also occur if a Nabothian cyst bursts – releasing the trapped mucus, sometimes along with small amounts of blood, with or without an unpleasant odour, appearing as spotting or discharge. These symptoms are usually short-lived, but if they persist, a visit to your gynaecologist is in order.

One final potential issue arises when there are a great many cysts, or when a Nabothian cyst is particularly large. In that case the doctor's view of the cervix during the examination may be restricted, and taking a proper cell sample for a smear test may be hindered. But this too is very rare.

When to see a doctor

If your symptoms are bothering you or won't go away, speak to your doctor. Book a gynaecological appointment if you notice spotting, pelvic pain or unusual discharge.

These complaints can point to a whole range of other conditions or infections that need to be diagnosed and treated – so do get a specialist's opinion as soon as you can. Did you know just how much vaginal discharge can reveal about your intimate health? We discuss the types and causes of vaginal discharge in detail HERE.

How Nabothian cysts are diagnosed

Nabothian cysts are common and entirely unremarkable – your gynaecologist will usually recognise what they are at first glance. The diagnosis is made during a simple routine check-up.

If there is any doubt about the nature of the cyst and confirmation is needed that it really is a Nabothian cyst, further investigations may be carried out, such as:

• ultrasound, magnetic resonance imaging (MRI) or computed tomography (CT) for a closer assessment of the cervix.
• colposcopy, to get a clearer view of the cervix and confirm whether it's a Nabothian cyst or another type of change.
• laboratory analysis of a fluid sample taken from inside the cyst, to confirm that it is indeed a cyst and not cancer (should there be any suspicion of this).

Treatment of Nabothian cysts

In principle, Nabothian cysts require no treatment as long as they remain symptomless and cause no discomfort.

If, however, they are so numerous or so large that a smear test and examination of the cervix aren't possible, they will need to be removed.

The doctor can open the cysts to determine whether they are malignant, or remove them using cryotherapy (freezing and destroying the cyst with liquid nitrogen) or electrocautery (using an electric current to heat and destroy the cyst).

All of these procedures are quick, can be carried out in a single appointment at the gynaecology clinic and have a short recovery time. You should be feeling well again within just a few days.

 Nabothian cysts and pregnancy

Many Nabothian cysts are discovered by chance – often precisely because of the routine check-ups carried out during pregnancy. And many of them form during this very period or after giving birth.

That's because the cervix, which is normally open to allow fluids out (menstruation) or in (semen), closes during pregnancy, thereby protecting the baby's development. After the birth, when new tissue covers the mucus-producing cervical glands, the cells can multiply excessively and block the mucus from draining away – and so Nabothian cysts form.

Even though they're generally harmless, do speak to your doctor if you experience pain during intercourse, bleeding or unusual discharge while pregnant. They'll recommend the appropriate treatment if needed.

Complications of Nabothian cysts

Cysts can themselves arise as a complication of a hysterectomy (surgical removal of the womb), but they don't in turn lead to serious complications and they pose no risk to your health.

The most common complication is that a smear test may be painful or impossible because of the size of the cysts. In that case they'll be removed. There's no cause for concern: even the largest Nabothian cysts can be removed without difficulty, leaving no medical problems behind afterwards.

It can also happen that these mucus-filled bumps burst, releasing their contents in the form of unusual, foul-smelling discharge and light bleeding. As a rule, these symptoms only last a short while.

 How to prevent Nabothian cysts

Nabothian cysts can't be prevented – but there's no need to worry about them either. There are plenty of other gynaecological problems worth focusing your prevention efforts on. So simply look after your intimate area and make sure you book regular appointments with your gynaecologist. Nabothian cysts are nothing to be concerned about.

What's the difference between a Nabothian cyst and cervical cancer

Although both Nabothian cysts and cervical cancer affect the cervix, they are fundamentally different.

A Nabothian cyst poses no risk to your health and in most cases causes neither symptoms nor any need for treatment. They're simply small white or yellowish bumps in which mucus has collected because healthy epithelial cells have blocked the glands.

Cervical cancer, by contrast, develops when atypical cells multiply uncontrollably – and it is extremely dangerous if not detected in time. Thanks to screening programmes (smear tests) and the HPV vaccine, it is now one of the less common cancers among women in the UK (around 3,300 new cases and 880 deaths a year, source: Cancer Research UK) — regular screening nonetheless remains important. In another blog article we've put together plenty more useful information on what cervical cancer actually is and how you can help prevent it.

Nabothian cysts are common, and as a rule your gynaecologist will recognise them immediately during a routine examination and be able to rule out the possibility of cancer. If any doubt remains, a fluid sample from the cyst can be sent to a laboratory to confirm its nature.

 What to expect if you have a Nabothian cyst

You can lead a perfectly normal life with a Nabothian cyst, as it shouldn't affect you in any way. As long as it causes no discomfort or other symptoms, no treatment is needed either – so don't worry. There's no reason to go looking for home remedies or alternative solutions. Do bear in mind, too, that these cysts won't disappear on their own – which again isn't a problem. Attend your gynaecological check-ups regularly and your doctor will tell you whether and when removal is necessary.