What is Endometrioma Chocolate Cyst?
Endometrioma Chocolate Cyst is a common condition in the female reproductive system. It is a condition in which endometrial tissue grows in other parts of the body (usually the ovaries in the pelvic area) outside of where the lining of the uterus would normally be located. Endometrium is known as a tissue that prepares to shed the lining of the uterus every month and thickens to accept a fertilized egg. However, in the case of endometrioma, this tissue separates from its normal location and spreads to other areas.
This condition usually occurs on or around the ovaries. Endometrioma usually occurs in the form of cysts filled with blood and is also called “chocolate cysts” due to the dark brown color of these cysts. The blood in the cysts clots over time, which leads to the characteristic chocolate color and fluid appearance of the cyst.
Endometrioma Chocolate Cyst is a chronic condition that usually causes pain and other pelvic symptoms. It can also be associated with infertility and is therefore a significant concern among women of reproductive age.
Endometrioma Symptoms and Diagnosis
Endometrioma Chocolate Cyst symptoms may include:
- Severe abdominal pain
- Painful menstrual cycle
- Pelvic pain
- Bleeding outside of menstrual period
- Pain during intercourse
- Pain during bowel movements
These symptoms are associated with menstrual periods and can change throughout the menstrual cycle. Diagnosis is usually made through a pelvic exam, ultrasound, and sometimes imaging tests such as MRI. A definitive diagnosis of endometrioma usually requires surgical removal of the cysts and sending them to pathology.
Endometrioma Symptoms and Diagnosis
Endometrioma Chocolate Cyst symptoms can occur during and outside of menstrual periods. Symptoms can vary from woman to woman and their severity can also vary. Here are some of the endometrioma symptoms:
Severe Abdominal Pain: Endometrioma Chocolate Cyst most commonly manifests itself with severe abdominal pain during menstrual periods. This pain is usually felt in the lower abdomen and can sometimes be accompanied by back and waist pain. The pain can become more severe at the beginning or middle of the menstrual cycle.
Groin Pain: Endometrioma Chocolate Cyst can cause constant or intermittent pain in the groin area. This pain can manifest itself as a feeling of pressure or tension in the groin.
Pain During Sexual Intercourse: Endometrioma Chocolate Cyst can cause pain during sexual intercourse. Pain can be felt especially during deep penetration or after orgasm.
Absent-Menstrual Bleeding: Endometrioma Chocolate Cyst can also cause bleeding outside of menstrual periods. This bleeding can usually be light, but sometimes it can be heavy and prolonged. When seen with other symptoms of endometrioma, non-menstrual bleeding is an important sign for diagnosis.
In addition, endometrioma can also cause symptoms such as painful bowel movements or urination during menstruation, constipation, diarrhea, difficulty conceiving, and blood in stool or urine during menstruation.
Diagnosis is usually made using imaging tests. Ultrasonography is a frequently used method to visualize endometrioma cysts and other changes in the ovaries. In addition, imaging techniques such as MRI (Magnetic Resonance Imaging) can be used to provide more detailed information.
Differences Between Endometrioma and Endometriosis
Endometrioma and endometriosis are two conditions that are often confused but are different. Here are the main differences between the two conditions:
Endometriosis:
Endometriosis refers to the growth of the endometrium outside the uterus, usually in the pelvic area and sometimes in the abdominal organs.
Symptoms: Endometriosis can present itself with symptoms such as pain associated with menstrual periods, groin pain, pain during intercourse, and bleeding outside of menstrual periods.
Diagnosis and Prognosis: Endometriosis is usually diagnosed with a surgical procedure called laparoscopy. During this procedure, the doctor can observe and diagnose pieces of tissue growing outside of the uterus.
Endometrioma:
Definition: Endometrioma is a subtype of the condition called endometriosis. It is a condition that occurs only in the ovaries and usually appears as cysts filled with blood.
Symptoms: Endometrioma can often cause symptoms similar to endometriosis. Symptoms such as severe abdominal pain, pelvic pain, and bleeding outside of menstrual periods are common.
Diagnosis and Prognosis: Endometrioma is usually diagnosed with imaging tests, especially ultrasound or MRI. In large or suspicious cases, laparoscopy may be performed.
That is, endometriosis generally refers to the presence of endometrial tissue growing outside the uterus, while endometrioma only describes cysts that occur in the ovaries. Therefore, endometriosis refers to a broader condition, while endometrioma is a subtype of endometriosis and represents a specific anatomical change in the ovaries.
Dangers and Complications of Endometrioma
Endometrioma Chocolate Cyst is not usually associated with cancer, but in some cases it can cause serious complications:
Risk of Ovarian Cancer: Endometrioma is not usually associated with cancer, but the presence of large endometriomas can increase the risk of ovarian cancer. This risk is especially high in women over the age of 40 and in the presence of long-term endometrioma. Therefore, women diagnosed with endometrioma should be followed regularly.
Damage to Tissues and Organs: Growing endometriomas can cause damage by pressing on surrounding tissues and organs. Endometriomas, especially those that reach large sizes, can compress the surrounding ovaries, uterus and other pelvic organs, which can lead to serious pain and discomfort.
Infertility: Endometrioma can affect fertility and cause infertility. As a result of endometrioma affecting the ovaries and uterus, the normal ovulation process can be disrupted and prevent a fertilized egg from implanting in the uterus. In addition, inflammation and adhesions caused by endometriomas can also make pregnancy difficult.
Serious Abdominal Pain: Large endometriomas can cause severe pain in the pelvic area. This pain can increase during menstrual periods and negatively affect a woman’s daily activities. The pain can increase over time and become chronic if left untreated.
For this reason, it is important for women diagnosed with endometrioma to be regularly monitored and treated if necessary. Early diagnosis and appropriate treatment can prevent or alleviate complications.
Endometrioma Treatment and Management
Endometrioma Chocolate Cyst treatment is individualized according to the severity of the patient’s symptoms, age, desire to conceive, and the size of the cyst. Treatment is usually done to control symptoms, reduce the size of the cyst, and prevent complications. Here are the common methods used for endometrioma treatment:
Drug Therapy: Various medications can be used to manage the pain and other symptoms caused by endometrioma. Painkillers, anti-inflammatory medications, and hormonal medications (such as birth control pills or progesterone-containing medications) can be used to relieve symptoms.
Surgery: Surgery is a frequently used definitive treatment option for Endometrioma Chocolate Cyst treatment. Surgery can be performed to remove endometriomas or drain the contents of the cyst. Surgical techniques such as laparoscopy or laparotomy can be used. Surgery may be preferred, especially if the cysts are large and other treatments are ineffective in managing symptoms.
Combined Treatment: In some cases, a combination of drug therapy and surgery may be necessary. For example, hormonal medications can be used to keep symptoms under control after surgery.
Fertility Concerns: Since Endometrioma Chocolate Cyst can have a negative impact on fertility, the treatment plan for women planning to conceive should also take into account fertility concerns. In this case, strategies to preserve fertility and increase the chance of pregnancy may be at the forefront.
Regular Follow-up and Monitoring: Regular follow-up and monitoring after treatment can help reduce the risk of endometrioma recurrence and detect potential complications early.
The most appropriate treatment plan for each patient should be determined according to the patient’s individual condition and needs. Therefore, endometrioma treatment should be determined after a detailed evaluation between the patient and Assoc. Prof. Dr. Esra Özbaşlı.
Misconceptions About Endometrioma
There are many misconceptions and misinformation about Endometrioma Chocolate Cyst. Here are some common misconceptions about endometrioma:
Only Seen in Older Women: Endometrioma is generally perceived as a problem of older women. However, this is a misconception. Endometrioma can also be seen frequently in young women of reproductive age and is a significant concern among young women.
Only Causes Abdominal Pain: Endometrioma is perceived as a condition that only causes abdominal pain. However, endometrioma can also cause various symptoms such as bleeding outside of menstrual period, pain during intercourse, groin pain, and painful defecation.
Does Not Affect Pregnancy: There is a misconception that endometrioma has no negative effect on fertility. However, endometrioma can affect fertility and make it difficult to get pregnant. Therefore, if women diagnosed with endometrioma are planning to get pregnant, this situation should be taken into consideration and appropriate treatment strategies should be determined.
Can Only Be Treated with Surgery: There is a misconception that endometrioma can only be treated with surgery. However, in addition to surgery, there are also drug therapy, hormone therapy, and combination treatment options for endometrioma treatment. The treatment plan should be determined according to the patient’s symptoms, age, desire to become pregnant, and the size of the cyst.
