Assoc. Prof. Dr. Taner Usta, specialist in obstetrics and gynaecology, explained the effect of pregnancy on the chocolate cyst.
There is a widespread belief that pregnancy is good for the chocolate cyst. This idea has been fixed in people’s minds since the beginning of the 20th century. For the chocolate cyst, pregnancy was recommended as a treatment method from the beginning of the 1950s and 1960s. In those periods, case reports of women with a chocolate cyst included information that the chocolate cyst had disappeared after pregnancy. However, as is known, case reports are among the data with the lowest scientific strength of evidence. They may not always reflect the facts. Today, pregnancy as a treatment does not appear in the international endometriosis management guidelines, and the idea that pregnancy eliminates the chocolate cyst is regarded as a myth.
The relationship between pregnancy and the chocolate cyst
Women with a chocolate cyst experience a change in the brain’s pain process, as in other chronic pain conditions. The nerves located especially in the pelvis are more sensitive than in women without chronic pain. The menstrual cycle irritates and stimulates these sensitive nerves and strengthens the pain pathways. For this reason, in those with a chocolate cyst the period is far more painful than a normal one. One of the ways of preventing the strengthening of the pain pathways is to stop regular menstruation completely. This is how women with a chocolate cyst are able to bring the pain-related complaint under control with the use of hormonal contraceptives. With such treatment methods it becomes possible to prevent the chocolate cyst from growing and to suppress the signs caused by the cyst.
Pregnancy can cause the chocolate cyst to shrink
Because women do not menstruate during pregnancy, it can be possible for the pain caused by the chocolate cyst to be relieved with pregnancy. In addition, the hormones secreted during pregnancy can prevent the cyst from growing or make it shrink. On the other hand, however, it is also possible that the pain related to the chocolate cyst becomes even worse because pregnancy puts extra pressure on the sensitive pelvic nerves. It is quite common for the pain that has decreased to return after the birth has taken place. Especially with the return of the menstrual cycle to its former state after the birth, these pains come back because there has been no long-term change in the chocolate cyst foci or in the pain pathways. The suppressive effect of pregnancy is temporary. Along with this, the probability of women with a chocolate cyst giving birth prematurely, having a caesarean, giving birth to a low birth weight baby and having a miscarriage is higher than in healthy individuals.
Assoc. Prof. Dr. Taner Usta
Specialist in Obstetrics and Gynaecology
www.drtanerusta.com