The chocolate cyst, in other words endometriosis, refers to cysts that form deep in the ovaries and contain a fluid resembling old, dark blood. Why they form is not yet fully known. The chocolate cyst is seen in roughly 5-10% of women of reproductive age. As long as chocolate cysts do not exceed a certain size, do not cause chronic and severe pain that affects the patient’s quality of life and no malignant changes are found on ultrasound or MRI, surgery is not preferred.
In some cases of chocolate cyst, deep endometriosis — another form of the disease — can be present at the same time. Deep endometriosis is a form that involves the bowel and the urinary tract and is not easy to detect. It carries a risk of causing silent kidney failure. It is important that this risk is not overlooked and that women with a chocolate cyst have their urinary tract and kidneys checked regularly.
What Are the Symptoms of a Chocolate Cyst?
The chocolate cyst can show symptoms such as bloating and cramps in the abdomen during the menstrual cycle, heavy vaginal bleeding, abnormal bleeding and spotting, lower back pain, pain in the legs, back pain, dark-coloured vaginal discharge, chronic pain in the groin, pain during sexual intercourse, painful bowel movements when going to the toilet and, in some women, infertility.
Is Endometriosis a Chronic Disease?
In women with endometriosis, which can sometimes be a chronic disease that cannot be completely eliminated, it is possible — though not always — to remove the endometriosis tissue completely with a surgical procedure. After the operation, however, treatment that suppresses endometriosis must be continued until the patient reaches menopause. In women of reproductive age, rises in the oestrogen level can cause the process of endometriosis formation and the disease itself to continue.
Endometriosis Is an Important Health Problem That Must Be Taken Seriously
About 40% of couples who have difficulty having children have endometriosis. According to studies there is an important link between endometriosis and infertility. Endometriosis can cause various disturbances in women’s reproductive physiology. In severe cases of endometriosis, the disruption of the anatomical relationship between the reproductive organs and the formation of adhesions can block the tubes and lead to infertility.
When endometriosis cannot be diagnosed and treated, irreversible infertility can develop. The tendency of the chocolate cyst to spread can damage the ovaries and lead to situations in which even IVF treatment cannot provide a solution.