Chocolate cyst

Chocolate cyst, also known as an endometrioma, is a type of ovarian cyst that forms when endometrial tissue (the mucous membrane that lines the inside of the uterus) grows in the ovaries. It is a common manifestation of endometriosis, a condition in which endometrial-like tissue grows outside the uterus in areas such as the ovaries, fallopian tubes, and the pelvic lining. This article provides an overview of chocolate cysts, including their symptoms, causes, diagnosis, and treatment options.

Symptoms

Chocolate cysts can vary in size and may not always produce symptoms. When symptoms do occur, they can include:

• Pelvic pain, especially during menstruation
• Pain during intercourse
• Painful bowel movements or urination during menstrual periods
• Heavy or irregular menstrual bleeding
• Infertility

Causes

The exact cause of chocolate cysts is not fully understood, but they are closely linked to endometriosis. Factors that may contribute to the development of endometriosis and chocolate cysts include:

• Retrograde menstruation, where menstrual blood containing endometrial cells flows back through the fallopian tubes into the pelvic cavity instead of leaving the body
• Immune system disorders
• Surgical scars, where endometrial cells attach to a surgical incision
• Hormonal imbalances

Diagnosis

Diagnosis of chocolate cysts typically involves a combination of medical history review, physical examination, and imaging tests such as:

• Ultrasound, which can help identify the presence of cysts on the ovaries
• Magnetic resonance imaging (MRI), which provides detailed images of the ovaries and can help distinguish chocolate cysts from other types of ovarian cysts
• Laparoscopy, a surgical procedure that allows a doctor to view the ovaries directly and take a tissue sample (biopsy) if necessary

Treatment

Treatment for chocolate cysts depends on several factors, including the size of the cyst, the severity of symptoms, and whether the individual wishes to become pregnant. Options include:

• Pain management with medications such as nonsteroidal anti-inflammatory drugs (NSAIDs)
• Hormonal therapies to suppress the growth of endometrial tissue
• Surgery to remove the cyst, which may be recommended if the cyst is large, causing significant symptoms, or if there's concern about ovarian cancer. Options include laparoscopy or laparotomy.
• Fertility treatments, if infertility is an issue

Prognosis

The prognosis for individuals with chocolate cysts varies. While treatment can relieve symptoms and improve fertility, endometriosis and chocolate cysts can recur. Ongoing management may be necessary to control symptoms and monitor for complications.

See Also

• Endometriosis
• Ovarian cyst
• Pelvic pain
• Infertility