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Chocolate cyst, also known as endometriosis; Endometriosis is the presence of a layer called endometrium, which covers the inside of the uterus, allows the baby to settle in the uterus at the beginning of pregnancy, and is shed with menstruation every month, in other places in the abdomen.
Rarely, it can occur in the scars of eyes, nose, lungs, previous abdominal surgeries. The endometrium tissue, which should normally be in the uterus, repeats its behavior in the uterus every menstrual period; In other words, these excess tissues grow with menstruation every month and are shed with bleeding. These rashes cause adhesions around the area where they are located.
When endometriosis settles in the ovaries, it causes cysts inside the ovary. During each menstrual period, as the endometrium tissue in the ovary bleeds under the influence of hormones, a cyst forms and the blood remaining in the cyst for a long time turns into a chocolate-like (dark brown) liquid over time. For this reason, these cysts are called 'chocolate cysts'. If the cyst grows untreated, it may turn around or rupture; in these cases, severe and urgent complaints may occur; Chocolate cysts larger than 3 cm should be surgically removed.
The exact cause of endometriosis is unknown. However, it is mostly attributed to some changes in the immune system and the placement of intrauterine cells in the abdomen in the blood flowing back into the abdomen during menstruation.
It can be seen in any woman of reproductive age. However, it is most common between the ages of 25-34. It is more likely to occur in women with diseases related to the immune system and in women with frequent and long menstrual periods. The risk is 4-8 times higher in those whose mother and sister have endometriosis. Those who have uterine abnormalities such as humpbacked uterus, uterine division, those who have had their first menstruation at the age of 11 or before, and those who have never given birth are also at higher risk.
Having a child, breastfeeding, using birth control pills are factors that reduce the risk of chocolate cyst. In addition, the use of intrauterine devices and tampons does not affect the risk of endometriosis. Abortion is also not a cause of endometriosis.
The two most important complaints of chocolate cyst are; pain and infertility. Pain may be in the form of constant lower abdominal pain, painful menstruation and painful sexual intercourse. The duration and severity of the pain usually increases as time passes and is often seen with low back pain. The reason to explain the pain may not be understood by ultrasound and blood tests. Endometriosis should be investigated in women who want to become pregnant but cannot conceive. Endometriosis can cause symptoms such as fatigue and weakness, diarrhea or constipation during menstruation, painful and bleeding urination, vomiting, nosebleeds, and bloody sputum. Some women with endometriosis may have no symptoms.
Endometriosis creates adhesions in the abdomen and prevents the healthy functioning of the tubes and ovaries. This makes it harder to be a child. In this case, medical or surgical treatments are performed. However, it should not be forgotten; Although the chance of conceiving increases after surgical treatment, it is not possible to say that the pregnancy is one hundred percent. If necessary, assisted reproduction techniques (vaccination, in vitro fertilization) are used.
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