Chocolate cysts are ovarian cysts filled with menstrual blood. They are part of a disease process called Endometriosis, a condition that happens when endometrial tissue (inner lining of the uterus) travels outside the uterus.
Apart from the ovaries, Endometriosis can be found in other places inside the pelvis (lower abdomen) and rarely in the upper abdomen or chest. The name “chocolate cyst” comes from thick, dark old blood that fills the cyst, giving it a chocolate-like appearance.
Who does it affect?
Anyone who menstruates can get Endometriosis. And only people with Endometriosis get ovarian endometriomas or chocolate cysts. The peak age is between 25years to 35years.
If you are diagnosed with this condition, immediately consult an ovarian cancer specialist Bhubaneswar.
What is the cause of a chocolate cyst?
Although Endometriosis affects approximately 10% of reproductive-age women worldwide, its exact cause is not yet understood. One common theory is that Endometriosis occurs when some endometrial-like tissue flows backwards during menstruation and becomes trapped within the ovary, producing cysts by gradually accumulating old blood.
How does chocolate cyst affect my body?
During the menstrual cycle (periods), the endometrial implants increase in size, causing pain, inflammation, and scarring. They usually present as asymptomatic ovarian masses with occasional pelvic pain, but some women have severe dysmenorrhea with menstrual irregularity. Because of anatomical distortion and reduced ovarian reserve in severe Endometriosis, some ladies have reduced fertility and require assisted reproductive techniques to conceive. There is an increased risk of first-trimester miscarriage and ectopic pregnancy.
The risk of cardiovascular diseases (stroke, myocardial infarction) is increased. There is a minimal increase in the risk of ovarian cancer which reduces after complete excision of endometriotic implants. The risk of cancer increases if the age is more than 45 years, the cyst size is more than 9cm with solid components inside, and there is a recent rapid increase in cyst size.
When should I suspect having Endometriosis?
Symptoms of Endometriosis include cyclical pelvic pain or dysmenorrhea. If symptoms affect daily activities, it is important to consult an ovarian cancer specialist Bhubaneswar for further investigation.
How are ovarian endometriomas diagnosed?
A thorough history and clinical examination are essential for diagnosis. Further imaging, such as ultrasonography (USG) or MRI, may be necessary, and some blood tests like HE4 CA125, CA19.9 may be needed to rule out cancer.
How can I prevent getting chocolate cysts or Endometriosis?
There is no known way to prevent Endometriosis or endometriomas. However, maintaining a healthy lifestyle and healthy weight can reduce its impact on daily life.
How are chocolate cysts treated?
The goal of treating chocolate cysts is to reduce pain, improve the chance of spontaneous conception, and exclude cancer while preserving as much ovarian function as possible.
Treatment depends on several factors, including:
• Age
• Symptoms
• Whether one or both ovaries are affected
• Whether or not you want to have children
• Whether any other organ is affected
The options are-
– Observation with serial sonography every 6-12 months- This is the preferred treatment for small asymptomatic cysts, as any surgery on ovaries risks reducing ovarian function.
– Surgery- Laparoscopic cystectomy is the surgery of choice. If immediate pregnancy is not desired, postoperative hormone therapy for 12-24 months is advised to reduce the recurrence of Endometriosis.
– Hormone therapy alone is usually not helpful in treating chocolate cysts, but it can help reduce pain associated with Endometriosis
The Bottom Line
Chocolate cysts or Endometriosis are common diagnoses in young women with abdominal pain or dysmenorrhea. Proper endometriosis and chocolate cysts management requires a complex approach that may require long-term hormone therapy and repeated surgeries.
For the most effective treatment, visit Dr. Ushashree Das who is an ovarian cancer specialist in Bhubaneswar. With a successful track record and years of experience, Dr. Usha will walk you through the complexities of Endometriosis for optimal health.