How Is the Diagnosis Made?
In problems such as period pain, infertility, painful periods, painful sexual intercourse, constipation, indigestion, bloating, abdominal pain or irregular periods, a specialist in obstetrics and gynaecology should be consulted without losing time. After a gynaecological examination and, if necessary, an ultrasound have been performed, if endometriosis (chocolate cyst) settled on the ovaries and adhesions related to endometriosis foci in other areas are seen on ultrasound, the disease should be investigated with the advanced imaging methods of computed tomography (CT) and magnetic resonance imaging (MRI) or with certain blood tests. In the gynaecological examination the vagina, the uterus, the bladder and the rectum are checked. If it is felt during the examination whether there is a change in the shape and size of the organs or whether any mass is present, an examination is made with a device that sends high-frequency sound waves into the vagina, that is, with transvaginal ultrasound. For a definite diagnosis it may be necessary to perform laparoscopy, in which the inside of the abdomen is visualised with a thin tube. With this method the severity of the endometriosis is also determined. In laparoscopy, which is a surgical procedure, the organs inside the pelvis and the other organs in the abdominal area can be visualised. The CA125 protein, which is a marker of tumours in some gynaecological cancers, can also be high in the blood of women with endometriosis. Since CA125 levels are also high in pregnancy, menstruation and other gynaecological conditions, although it is not regarded as a definite diagnosis, there is benefit in checking it.
How Are Endometriosis and Endometrioma (Chocolate Cyst) Diagnosed and Treated
The condition defined as the chocolate cyst, or by its other name the disease of endometriosis, can also affect other areas in the body. It occurs when the inner tissue of the uterus, in which the pregnancy settles, settles in another part of the body, especially on the ovaries. The inner structure of the cysts is exactly like the tissue of the uterus. Indeed, it gives the same response to the reproductive hormones in the woman as the inner tissue of the uterus does. Every time the period comes, bleeding occurs inside the cyst. This bleeding accumulates inside and over time takes the form of a thick, brown fluid. Because this fluid resembles melted chocolate, these cysts have been given the name chocolate cyst. Chocolate cysts can progress in some patients without giving any symptom, or they can cause, in patients, severe pain during the period and during sexual intercourse that does not pass with painkillers, irregular periods or the failure of pregnancy to occur. For cysts that have effects which lower a woman’s quality of life and that affect her ability to have children, suitable treatments are used. They are applied according to the patient’s age, her wish to become pregnant and the degree of discomfort of the symptoms, the size of the cyst, whether or not she can have children and the severity of the pain. Drug treatment or surgery may come into question. Or both drug treatment and surgery can be carried out together.