Chocolate Cyst Treatment

Chocolate cyst is a disease that can negatively affect women's reproductive health and can lead to infertility in progressive cases. These cysts, which are formed when the endometrium tissue lining the uterus grows outside the uterus, are usually characterized by painful menstrual periods and chronic groin pain.

What is a chocolate cyst?

A chocolate cyst (endometrioma) is when the lining of the uterus grows outside the uterus and forms sacs filled with dark brown fluid. The fluid in these sacs is called “chocolate cyst” because it resembles the appearance of chocolate due to its dense consistency and brown tone.

Chocolate cysts usually develop in the ovaries and can grow over time, causing menstrual irregularities, pelvic pain and fertility problems.

What is Endometriosis?

Endometriosis is a condition in which the lining of the uterus (endometrium) grows in different areas outside the uterus. Although this tissue develops outside the uterus, it reacts to hormones every month depending on the menstrual cycle, thickens and tries to shed with bleeding. However, because it is outside the uterus, it cannot be excreted from the body and can cause inflammation, adhesions and chocolate cysts over time.

Every person with chocolate cysts has endometriosis, but not every endometriosis patient has chocolate cysts.

What causes a chocolate cyst?

Although the exact cause of chocolate cysts is not known, some factors are thought to contribute to the development of the disease.

Factors that cause chocolate cyst formation:

• Genetic predisposition: Women with a family history of endometriosis or chocolate cysts are at higher risk.
• Hormonal imbalances: High levels of estrogen can cause endometriosis to spread.
• Immune system disorders: When the body is unable to destroy endometrial tissue growing outside the uterus, the disease can progress.
• Structural disorders of the uterus: Some congenital uterine abnormalities can predispose to the development of endometriosis.
• Reverse menstruation (retrograde menstruation): When the lining of the uterus flows backwards through the fallopian tubes and spreads into the abdominal cavity, endometrial cells can grow in the wrong areas.

What are the Symptoms of a Chocolate Cyst?

Women with chocolate cysts usually experience severe pain and menstrual irregularities. However, some patients may have no symptoms at all and the cyst may be detected by chance during routine examinations.

• Severe menstrual pain (dysmenorrhea): A menstrual cycle that is longer and more painful than normal.
• Chronic groin and pelvic pain: Pain in the groin and lower back can be felt even outside the menstrual period.
• Pain during sexual intercourse: Discomfort may occur during intercourse due to tenderness and adhesions in the vaginal area.
• Menstrual irregularities: Excessive bleeding or irregular menstrual cycle.
• Infertility: It can cause adhesions in the ovaries and fallopian tubes, making it difficult to get pregnant.
• Bowel and bladder problems: Symptoms may include bloating, constipation, frequent urination or pain when urinating.

Symptoms can vary from person to person and some women have no symptoms at all.

 

Who Can Get Chocolate Cysts?

 

Who Can Get Chocolate Cysts?

Chocolate cysts are most commonly seen in women of reproductive age. These cysts, which are more common in women with endometriosis, start to show symptoms especially between the ages of 20-30.

Genetic predisposition: Women with a family history of endometriosis or chocolate cysts are at higher risk.
Hormone imbalances: High levels of estrogen can predispose to the formation of chocolate cysts.
Never having given birth: Chocolate cysts are more common in women who have not given birth.
Advanced age: Although chocolate cysts usually occur during reproductive age, they can also occur in the pre-menopausal period.
Immune system weaknesses: The body's inability to prevent abnormal tissue growth can trigger the development of endometriosis.

Does Chocolate Cyst Cause Infertility?

Chocolate cysts can negatively affect fertility and make it difficult to get pregnant. The size of the cyst, its location and the general health of the patient are factors that determine its effects on infertility.

It can damage the ovaries: Chocolate cysts can put pressure on the ovarian tissue and disrupt the ovulation process.
They can block the fallopian tubes: This can prevent the egg from meeting the sperm, making natural fertilization difficult.
It can affect the lining of the uterus: It can increase the risk of miscarriage by making it difficult for the embryo to attach to the uterus.
It can cause hormonal imbalances: It can cause menstrual irregularities and lower egg quality.

Not all women with chocolate cysts experience infertility, but about 30-50% of women with chocolate cysts may experience fertility problems.

What happens if a chocolate cyst is not treated?

Untreated chocolate cysts can grow over time and cause severe pain, menstrual irregularities and fertility problems.

Chronic pelvic pain: Groin and lower back pain that negatively affects daily life can be observed.
Severe menstrual cramps: Women with chocolate cysts often have menstrual periods that are more painful than normal.
Pain during sexual intercourse: There may be increased sensitivity in the vaginal area and discomfort during intercourse.
Increased risk of infertility: It can negatively affect ovarian function, making it difficult to get pregnant naturally.
Bowel and bladder problems: Growing cysts can cause digestive problems, such as pain when urinating or constipation.

How is a chocolate cyst treated?

Chocolate cyst treatment is planned individually depending on factors such as the patient's age, symptoms, size of the cyst and desire to have children.

Drug Treatment
Hormone therapy: Birth control pills or hormone-regulating drugs can stop a chocolate cyst from growing.
Painkillers: In mild cases, it can be used to reduce pain.
Laparoscopic Surgery (Closed Surgery)
It is one of the most effective methods for removing a chocolate cyst without damaging the ovaries.
Since it is a minimally invasive method, the healing process is faster.
Open Surgery
It can be applied when large and diffuse cysts need to be removed.
It may require a longer recovery period.
Fertility Protective Treatments
Assisted reproductive techniques such as in vitro fertilization (IVF) can be used for patients who want to have children.

The treatment process depends entirely on the patient's health condition and the doctor's recommendations.

How is chocolate cyst surgery performed?

Chocolate cyst surgery is usually performed laparoscopically (closed). General anesthesia is applied and the patient does not feel any pain during the operation. Small incisions are made in the abdomen and the uterus is accessed with a camera. Chocolate cysts are carefully removed without damaging the ovaries. After the procedure is completed, the incision sites are closed with aesthetic sutures. The patient is usually hospitalized for 1-2 days and then discharged. Thanks to closed surgery techniques, patients can recover in a shorter time and return to their normal lives.