Nabothian Cysts: The Harmless Cervical Bumps Your Doctor Found During Your Pap Smear. What You Need to Know

Pelvic Pain & Conditions
Written By Becky Freeman

If you have ever been told during a routine pelvic exam or Pap smear that you have "nabothian cysts" on your cervix, your first reaction was probably some version of mild panic followed by a frantic internet search. The word "cyst" attached to any part of your reproductive system tends to set off alarm bells and when it involves the cervix, the mind immediately jumps to cancer. So let us set the record straight right away: nabothian cysts are among the most benign findings in all of gynecology. They are extraordinarily common, almost never cause symptoms, rarely require any treatment, and have no connection to cervical cancer. Understanding what they actually are can transform a confusing and anxiety-provoking diagnosis into something far more manageable because in most cases, the answer is simply that there is nothing to manage at all

What Is a Nabothian Cyst?

A nabothian cyst sometimes called a nabothian follicle or mucinous retention cyst is a small, smooth, mucus-filled bump that forms on the surface of the cervix. They are named after Martin Naboth, the German anatomist who first described them in 1707, and they have been observed in women ever since as one of the most routine cervical findings a gynecologist can encounter.

To understand why they form, it helps to know a little about the anatomy of the cervix. The cervix the lower, narrow end of the uterus that extends into the vagina is lined with two different types of cells: squamous cells on the outer surface and columnar cells that line the inside of the cervical canal and the glands within it. The columnar cells in these glands produce mucus, which plays an important role in the reproductive cycle, changing in consistency throughout the month to either block or assist the passage of sperm.

The area where these two cell types meet is called the transformation zone, and it is an area of constant, healthy cellular activity. As part of normal cervical maintenance, the body continuously replaces older columnar cells with new squamous cells in a process called squamous metaplasia. Occasionally, as this replacement happens, the new squamous cells grow over the openings of the mucus-producing glands before they have fully drained, trapping the mucus inside. That trapped mucus accumulates and stretches the gland into a small, round, fluid-filled sac a nabothian cyst.

How Common Are They?

Nabothian cysts are remarkably common across all reproductive age groups, and the exact prevalence is difficult to pin down precisely because the vast majority go unnoticed and unreported. Research and clinical observation suggest they are present in a significant percentage of women who have ever been pregnant or given birth, since the process of childbirth and cervical healing is one of the most common triggers for the glandular blockage that leads to cyst formation. They are also frequently found in women between the ages of 30 and 50, during and after phases of cervical inflammation or infection, and following certain cervical procedures.

Most nabothian cysts are tiny, ranging from a few millimeters to one or two centimeters in diameter, though occasional larger cysts are reported. They can appear as a single isolated bump or as a cluster of multiple small cysts scattered across the cervical surface. On visual examination they tend to look smooth, round, and either white, yellowish, or slightly translucent which is why they are sometimes described as looking like small pearls embedded in the cervical tissue.

What Causes Them to Form?

Several well-documented situations create the conditions under which nabothian cysts are likely to develop. Pregnancy and childbirth top the list: as the cervix stretches, heals, and undergoes significant tissue remodeling after delivery, new squamous cells frequently grow over gland openings, trapping mucus beneath them. This is why nabothian cysts are so commonly found in women who have had one or more pregnancies.

Chronic cervicitis persistent low-grade inflammation of the cervical tissue, often from recurrent infections, bacterial vaginosis, or irritation triggers repeated cycles of tissue repair that increase the likelihood of glandular blockage. Previous cervical procedures such as cryotherapy, laser treatment, loop electrosurgical excision procedure (LEEP), or cervical biopsies can also stimulate healing responses that result in nabothian cyst formation. Hormonal fluctuations during the reproductive years influence the activity of the transformation zone and contribute to how actively the cervix undergoes this cellular remodeling process.

Symptoms or the Lack Thereof

Here is the most important thing to understand about nabothian cysts: the overwhelming majority of people who have them experience absolutely no symptoms whatsoever. Most nabothian cysts are discovered entirely by accident during a routine pelvic exam, Pap smear, or transvaginal ultrasound done for a completely unrelated reason. A person can carry nabothian cysts for years or even decades without ever knowing they are there.

When symptoms do occur, they are almost always associated with cysts that have grown unusually large or with multiple cysts clustering together in a way that puts pressure on surrounding tissue. In these less common cases, a person might notice a mild sense of pressure or fullness in the lower pelvis, occasional light spotting or minor bleeding after intercourse or a cervical exam, or very rarely a feeling of heaviness or mild discomfort in the vaginal area. Pain is not a typical feature of nabothian cysts and, if you are experiencing significant pelvic pain, it warrants investigation for other causes rather than attribution to a nabothian cyst alone

‍In rare instances, very large nabothian cysts can distort the shape of the cervical opening enough to make it difficult for a healthcare provider to obtain a satisfactory Pap smear sample or to perform other cervical examinations. This is one of the practical situations in which treatment becomes relevant, not because the cyst is dangerous, but because it is getting in the way of necessary monitoring

How Are Nabothian Cysts Diagnosed?

Diagnosis is usually straightforward and often requires nothing more than a routine pelvic exam. A trained gynecologist or healthcare provider can typically identify nabothian cysts on visual inspection of the cervix, where they appear as smooth, round bumps on the cervical surface. Their characteristic appearance small, well-defined, fluid-filled, and translucent or yellowish is usually distinctive enough to identify them on sight.

When a more detailed look is needed, or when the appearance of a cyst is in any way atypical, a colposcopy may be performed. This is a procedure in which a specialized magnifying instrument is used to examine the cervix in close detail, allowing the clinician to assess the size, number, depth, and surface characteristics of any bumps or abnormalities. Colposcopy is particularly useful for distinguishing nabothian cysts from other cervical lesions that require different management

A transvaginal ultrasound is another excellent diagnostic tool, particularly for cysts that are larger or located deeper within the cervical tissue where visual examination alone may not provide a complete picture. On ultrasound, nabothian cysts have a characteristic appearance: they are round with smooth edges, filled with anechoic fluid, and show no internal solid components or blood flow on Doppler imaging features that clearly distinguish them from malignant lesions. For ambiguous or unusual cases, an MRI or CT scan can provide even more detailed soft tissue imaging to confirm the benign nature of the cyst

Nabothian Cysts vs. Cervical Cancer: Understanding the Difference

This is the comparison that generates the most anxiety, and it deserves a clear, direct answer. Nabothian cysts and cervical cancer are fundamentally different conditions that look quite different on examination and imaging. Nabothian cysts are smooth, round, well-defined, fluid-only structures with no blood supply of their own. Cervical cancers, by contrast, tend to appear as irregular, asymmetrical, solid or mixed solid-and-fluid masses with internal vascularity visible on Doppler ultrasound, and they are associated with abnormal Pap smear results and positive high-risk HPV testing

A nabothian cyst will never turn into cervical cancer, and having nabothian cysts does not increase your risk of developing cervical cancer. The two conditions arise from entirely different processes one from a blocked mucus gland and the other from abnormal cellular changes driven by persistent HPV infection. The Canadian Cancer Society, Mayo Clinic, and Cleveland Clinic all classify nabothian cysts as non-cancerous and generally requiring no treatment

That said, there have been rare documented cases in which a cervical mass initially presumed to be a nabothian cyst turned out on biopsy to be an early cervical adenocarcinoma. This is why any cervical cyst with atypical features unusual size, irregular borders, solid components on imaging, associated abnormal bleeding, or an atypical Pap smear should be evaluated thoroughly rather than simply assumed to be benign. When in doubt, a biopsy provides definitive clarity and peace of mind

Treatment: Usually None Required

The standard medical recommendation for the vast majority of nabothian cysts is no treatment at all. Because they are benign, asymptomatic, and do not progress to cancer, intervention is simply not warranted in most cases. Regular monitoring during your routine pelvic exams ensures that any change in size or character is noted promptly

When a nabothian cyst does warrant treatment because it has grown large enough to cause symptoms, is obscuring the cervical opening, or has an appearance that makes it difficult to rule out something more serious several simple, minimally invasive procedures are available. Electrocautery ablation uses targeted electrical currents to heat and destroy the cyst tissue. Cryotherapy freezes the cyst using liquid nitrogen, causing the tissue to break down and be naturally reabsorbed by the body. Both are outpatient procedures typically performed in a clinic setting, require little to no downtime, and carry minimal risk of complications. For cysts with uncertain features that require histologic evaluation, surgical excision may be performed so that the removed tissue can be sent to a laboratory for analysis

Antibiotics are occasionally prescribed when there is evidence of a secondary infection or active cervicitis contributing to cyst formation, but they do not directly treat or shrink existing cysts.

When to Talk to Your Doctor

If you have been told you have nabothian cysts after a pelvic exam, Pap smear, or ultrasound, the most important next step is simply a direct conversation with your healthcare provider about what was found, what it looks like on examination or imaging, and whether any follow-up is recommended. For most people, the answer will be routine monitoring at your regular well-woman visits, with no additional procedures required.medicalnewstoday+1

Reach out to your provider sooner rather than later if you develop any new symptoms such as unusual vaginal discharge, unexpected bleeding between periods or after sex, pelvic pain, or if a follow-up exam shows that a previously identified cyst has grown significantly. Stay current with your Pap smear and HPV screening schedule, because while nabothian cysts themselves are harmless, maintaining regular cervical cancer screening is one of the most effective health choices you can make regardless of cyst status

A nabothian cyst is not a warning sign, not a precursor to cancer, and not something that requires you to lose sleep. It is one of the most common, most benign findings in women's health proof that sometimes the most unsettling-sounding diagnoses turn out to be the most reassuring ones

“This article is based on current medical guidance and research from the following trusted sources:”

Resources and Sources

About the Author

Becky Freeman is the founder of BVTalks® and Bee Vee Clean. She focuses on women’s intimate health, vaginal microbiome education, and creating practical, easy-to-understand content for everyday care.

Disclaimer: This article is for education only and is not a substitute for personal medical advice. Always talk to your own clinician about your symptoms and treatment options.

Becky Freeman https://www.bvtalks.com
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