What causes chocolate cyst? What are the symptoms?

Cysts can be defined as pathological cavities that can occur in bone tissue or soft tissue and contain a liquid or semi-solid puree-like substance. Cysts formed by the spread and settlement of the tissue layer called endometrium in the uterus to the ovaries are called ovarian cysts. It is also called chocolate cyst and is a gynecological disease characterized by complaints such as intense pain and increased bleeding during menstrual bleeding.

What are the Symptoms of Chocolate Cyst?

• Severe pain and increased bleeding during menstrual bleeding (60-80%)
• Complaint of intermittent pain in the abdomen and groin area (30-50%)
• Infertility, (30-40%)
• Complaint of severe pain during sexual intercourse (25-40%)
• Irregularity in the menstrual cycle and bleeding in the form of spotting before menstruation (10-20%)
• Complaints of pain and bleeding during urination (1-2%)
• Indigestion and bloating feeling due to slow bowel movements

While all these cyst symptoms can be seen at different rates, cases may also be encountered in which no symptoms or complaints are observed.

Chocolate Cyst Risk Factors

Chocolate cyst is the most common gynecological disorder among uterine cyst cases. Although there are no direct causes of the disease, some factors that affect the development of ovarian cysts can be listed.

• Menstrual cycle characteristics: first menstrual bleeding at the age of 11 or before, history of painful menstruation at an early age, long and heavy menstrual bleeding, irregular and frequent bleeding
• Family history: Women who have a first-degree relative with chocolate cysts are 4-10 times more likely to suffer from chocolate cysts.
• Environmental factors: chemicals that damage the endocrine system directly or indirectly disrupt hormonal balance and harm reproductive health. Studies have shown that the risk of chocolate cyst and infertility due to chocolate cyst is higher in those who are in contact with formaldehyde, chemical powders and organic solvents; It reveals that it is more common in the agricultural sector or farm workers, stewardesses and healthcare workers.

What are the Treatments for Chocolate Cyst?

Chocolate cyst treatment methods can be applied in two ways: pharmacological and surgical treatment. While the treatment method to be applied is determined by the physician according to the severity of the disease, surgical treatment is avoided in younger age groups and drug treatment is preferred. While the aim of medical drug treatment is to suppress the development and spread of chocolate cysts by reducing the estrogen hormone level, the aim of surgical treatment can be summarized as removing all cysts and opening adhesions.

It can be said that the disease recurs after 2 years in approximately 50% of the patients who received drug treatment, and in patients who underwent chocolate cyst surgery, the symptoms are observed after 1 year and a reoperation is required within 5 years. Therefore, even after chocolate cyst treatment, routine checks should be continued and the risk of recurrence should not be ignored.

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