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 hormones. 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.

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 cyst can cause internal bleeding and poses need to immediate medical attention.


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

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, regular pelvic examination can help in diagnosing the disorder at early stages which are easier to be cured.

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