Chocolate cysts are ovarian sac or pouch filled with fluids and old blood. It is also known as endometriomas and they are not cancerous. A chocolate cyst is formed when an endometrial tissue abnormally grows and attaches in the ovaries.

These patches of endometrial cells may form a small cyst that eventually multiplies into more cysts when triggered by hyperactive glands, unhealthy diets and lack of hormonal balance. In the absence of pregnancy, the endometrial tissue breaks up from the uterus during the menstrual cycle. However, in endometriosis, this doesn’t occur and instead, the blood collects and irritates the surrounding tissues.

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Family history of chocolate cyst makes the females more likely to develop this condition. The reverse flow of menstrual blood into oviducts, history of autoimmune disorders and any injury to the uterus are other contributing risk factors of developing chocolate cysts. Females with chocolate cysts may not be able to conceive due to malfunctioning of ovaries.

Chocolate cysts may cause torsion of ovaries, that is, shifting of ovaries from their usual location leading to nausea, pelvic pain and vomiting. In severe cases, rupture of the cyst can cause internal bleeding and poses need to immediate medical attention.
chocolate cysts

Symptoms

  • Painful menstrual cycle
  • Pain during sexual intercourse
  • Irregular and/or heavy bleeding during periods
  • Heaviness of abdomen
  • Pain during exercise

Chocolate cyst, also known as ovarian cyst, ovarian endometrioma and cystic ovarian mass on a human physiology and pathology basis, is commonly named thus, owing to the dark brownish, clumpy bulk that resembles a piece of molten chocolate. Composed of blackened fluids including old menstrual blood and decayed tissue, these endometrial lumps abnormally develop, in either only one, or both the ovaries simultaneously.

Besides agonizing cramps throughout menstrual cycles/periods and intense pain during intercourse, chocolate cysts are triggered more often, due to certain risk factors and at times, also give rise to extreme complications of infertility.

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Risk Factors

Certain aspects make a woman more prone to developing chocolate cysts in the ovaries, such as:

Prominent hormonal problems like thyroid, PCOS and regular intake of prescription fertility drugs, which cause harmful fluctuations in progesterone, estrogen levels

Infections in the pelvic region, which, if left unattended to, can spread to the neighbouring organs, tissues and afflict the ovaries

Prior occurrences of ovarian cysts, which even after healing completely, can arise again after months or even years

Complications 

The foremost downside of chocolate cysts is the heightened event of infertility in women. Although extensive research is still being conducted to determine the exact mechanism by which endometriomas result in a decline in fertility, medical experts have determined inflammation to be a key reason.

As abnormal growths, filled with fluids and wastes, invariably lead to massive swelling, a rupture in ovarian structures, they give rise to inflamed portions, hampering the ability of the ovaries to produce healthy eggs. It is hence advised to seek professional medical treatment from a gynaecologist, as soon as painful and irregular periods occur often. This ensures proper remedial measures are given to the woman, to restore hormonal balance and optimal fertility functions.

Diagnosis And Treatment

A gynaecologist may diagnose large chocolate cyst by collecting history and doing a pelvic examination. A small cyst may be diagnosed by doing trans vaginal ultrasound, X-ray or blood test.

Treatment of chocolate cyst includes removal of ovaries in older women; though, it is not recommended for women who are hoping to conceive in future. The larger cysts causing painful periods are mostly removed by surgery.

Due to associated complications and possible sterility, a regular pelvic examination can help in diagnosing the disorder at early stages which are easier to be cured.