Chocolate Cyst Treatment

What is a Chocolate Cyst?

Chocolate cyst, or ovarian endometrioma as it is known in medicine; It is a condition in which the endometrium tissue, which is responsible for lining the inner part of the uterus, develops on the ovarian tissue outside the uterus and causes various complaints. Clinically, the development of endometrial tissue in different body parts is called endometriosis. In this sense, chocolate cyst can be said to be a subtype of endometriosis

What Causes Chocolate Cyst?

Since chocolate cyst is a cyst formation of endometriosis tissue developing on the ovary, it is accepted that this disorder develops due to endometrial tissues shed from the uterus. In this sense, any health problem that may facilitate the shedding of endometrial tissue onto the ovary is a risk factor for chocolate cyst development. The following conditions may be considered risk factors for developing chocolate cysts:
Anatomical Problems in the Uterus
Presence of septum tissue in the inner part of the uterus; It may cause the development of benign tumors such as myomas and fibromas in the uterine wall. Similarly, anatomical problems that may trigger endometrial tissues to leak back into the ovary during the menstrual cycle may result in a chocolate cyst.
Imperforate Hymen
Similar to the uterus, problems such as imperforate hymen (closed hymen) in the cervix or vagina, which can prevent menstrual bleeding from flowing, can cause chocolate cysts to form.

Disturbances in Hormonal Balance

• Excessive secretion of estrogen hormone;
  The risk of developing a chocolate cyst increases in cases where menstrual bleeding occurs more frequently than normal, is more abundant, or lasts too long.
• Surgical History:
  In surgical procedures performed on the uterine wall, such as cesarean section, endometrial tissue may escape outside the uterus and cause endometriosis and chocolate cyst.
• Family History:
  People who have endometriosis in their first-degree relatives in the family are more likely to develop the same disease and chocolate cyst than other people.

What are the Symptoms of Chocolate Cyst?

Chocolate cyst can cover the ovarian tissue and cause disruption of the normal functions of the tissue in healthy people. At the same time, it may cause different levels of damage to the ovarian tissue as a result of various events that occur in the construction and destruction cycle. In this context, the following symptoms may be observed in people who develop chocolate cysts:

• Painful and/or irregular menstrual cycle
• Menstrual pain that does not go away with painkillers
• Abdominal, lower back or pelvic pain
• Irregular menstrual bleeding
• Painful sexual intercourse

What to Do in the Treatment of Chocolate Cyst?

When determining how to treat chocolate cyst; Various factors are taken into consideration, such as the patient's age, the severity and frequency of symptoms, and the plan to have children. According to these factors, the most appropriate treatment method for the patient is planned. In this regard, symptomatic treatment can be carried out by keeping endometriosis under control with various drug treatments, and the aim is to completely eliminate the problem with different interventional treatment methods.
When the cyst is small in size and does not cause serious discomfort affecting the quality of life, only follow-up can be recommended. Again, in cysts that cause mild symptoms, the symptoms of chocolate cyst can be relieved by applying hormone balance regulating drug treatments such as birth control pills. Although this treatment method controls the disease, it does not completely remove the chocolate cyst.
There are also drug treatments that aim to treat endometriosis tissue by shrinking it. In this context, GnRH hormone analogs or antagonists that regulate the hormone system are frequently used in treatment. Since this treatment method is long-term and causes an artificial menopause in the patient, it may be necessary to regulate it under the supervision of a physician and, when necessary, additional treatment methods may be needed in terms of side effects.
Surgical method is preferred in cases of severe pain attacks, cysts larger than four centimeters, women who develop infertility, or cysts that may develop into cancer. In this method, called ovarian cystectomy, the cyst is removed along with the surrounding tissues through a closed (laparoscopic) surgery.