Endometriosis, known among the public as the chocolate cyst, arises when the uterine tissue called the endometrium forms in areas of the body outside the uterus. Outside the uterus these tissues can be seen in the ovaries, in the fallopian tubes and even in the abdominal cavity.
Inside the cysts that form there is in fact menstrual blood that cannot be expelled from the body. Because of their colour and shape these cysts are called chocolate cysts. In cases where they cause damage, irritation or obstruction in the ovaries or the fallopian tubes, the chance of becoming pregnant falls.
The chocolate cyst causes complaints such as extremely painful menstrual periods, chronic pain in the pelvic region, pain during sexual intercourse and bowel discomfort. Spotting or light bleeding between periods is also among these signs.
In this article I will also try to answer one of the most frequently asked questions about the chocolate cyst, which is among the causes of infertility in women: what happens to the chocolate cyst during pregnancy.
Pregnancy and the Chocolate Cyst
Today, when many women with a chocolate cyst become pregnant the signs of the cyst generally decrease and in some patients disappear completely, so it is assumed that the cyst has shrunk or disappeared altogether.
But is that really the case? In the 1950s and 60s pregnancy was among the important treatment methods for the chocolate cyst. However, this is entirely a myth.
In modern medicine today pregnancy is not accepted as one of the treatment methods for the chocolate cyst. With pregnancy, menstruation is suppressed in the body. In this way the pain caused by the chocolate cyst also disappears.
The complaints that disappear with pregnancy are generally seen again after birth. There is no evidence that with pregnancy the lesions of the chocolate cyst, or the pain they cause, disappear completely and are never seen again.
In addition to all this information, it is thought that with the progesterone hormone that rises during pregnancy the endometrial growth will shrink, and indeed this is not entirely wrong. Even so, it cannot be generalised that the same shrinkage will occur in all endometriosis patients during pregnancy. There are also data indicating that in some women the signs of the chocolate cyst become more severe during pregnancy.
Beware of the Dangers of the Chocolate Cyst in Pregnancy!
Pregnancy may push the chocolate cyst back to some extent. But does the chocolate cyst cause problems in pregnancy? The chocolate cyst can have some important negative effects on pregnancy.
In pregnancy the chocolate cyst significantly increases the risk of pre-eclampsia, placenta previa, premature birth, premature rupture of the membranes, a low birth weight baby or miscarriage. Placenta previa is the name given to the placenta lying very low in the uterus, covering part or all of the cervix.
Placenta previa puts the life of both the mother and the baby at risk during birth. It is also known that the rate of caesarean birth is higher in women with a chocolate cyst. In such situations caesarean birth is generally preferred.
Because the chocolate cyst can put both the mother and the baby at risk during pregnancy, pregnancy is not recommended as a treatment method. I would also like to point out that the risks mentioned here are not seen in every pregnant woman with an endometrioma.
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