What causes chocolate cysts? What are their symptoms?

Cysts can be defined as pathological cavities that can occur in bone or soft tissue, containing a liquid or semi-solid, purée-like substance. Cysts that form from the spread and implantation of the tissue layer called endometrium within the uterus to the ovaries are referred to as ovarian cysts. These are also known as chocolate cysts and are a gynecological condition characterized by intense pain and increased bleeding during menstrual periods.

What Are the Symptoms of Chocolate Cysts?

Severe pain and increased bleeding during menstruation (60-80%)
Intermittent pain in the abdominal and groin area (30-50%)
Infertility (30-40%)
Severe pain during sexual intercourse (25-40%)
Irregularities in the menstrual cycle and spotting before menstruation (10-20%)
Pain and bleeding during urination (1-2%)
Indigestion and bloating due to slowed bowel movements

All these cyst symptoms can be seen in varying degrees, and cases may also occur where no symptoms or complaints are observed.

Risk Factors for Chocolate Cysts

Chocolate cysts are the most commonly encountered gynecological disorder among cyst cases in the uterus. Although there are no direct causes associated with the disease, some factors that may influence the development of ovarian cysts can be listed.

Menstrual Cycle Characteristics: Early onset of menstruation before age 11, history of painful menstruation at a young age, long and heavy menstrual bleeding, irregular and frequent bleeding
Family History: Women with first-degree relatives who have chocolate cysts are 4-10 times more likely to experience chocolate cyst disorders.
Environmental Factors: Chemicals that harm the endocrine system disrupt hormonal balance directly or indirectly and damage reproductive health. Studies have shown that the risk of chocolate cysts and infertility associated with chocolate cysts is higher in those who come into contact with formaldehyde, chemical powders, and organic solvents, as well as in agricultural workers, farm employees, flight attendants, and healthcare workers.

What Are the Treatments for Chocolate Cysts?

Treatment methods for chocolate cysts can be applied in two ways: pharmacological and surgical treatment. The treatment method to be applied is determined by the physician according to the severity of the disease, while medication is preferred over surgical treatment in younger age groups. The goal of medical treatment is to suppress the development and spread of the chocolate cyst by lowering estrogen hormone levels, whereas the goal of surgical treatment can be summarized as removing all cysts and addressing adhesions.

It can be stated that in approximately 50% of patients undergoing medical treatment, the disease recurs after 2 years, while in patients undergoing chocolate cyst surgery, findings are observed 1 year later, and the need for reoperation arises within 5 years. Therefore, routine check-ups should continue even after chocolate cyst treatment, and the risk of recurrence should not be overlooked.

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Last Updated Date: 06 April 2022

Publication Date: 06 April 2022