A chocolate cyst is a condition that is commonly found in women who are in reproductive age and have endometriosis. In medical terms, it is also known as an endometriotic cyst. It is a condition in which an ovarian cyst is filled with old blood and can affect the working of ovaries and even lead to infertility.
Chocolate Cyst: Causes
Any menstruating female can develop endometriosis. It’s more likely to happen between ages 25 and 40. It is hypothesized that when the menstrual blood flows, some of it flows back down the fallopian tubes and gets embedded into the surroundings of the uterus or the uterine wall. The endometrial cells are like small seeds and slowly grow bigger into cysts. Whichever part they get embedded on, whether it is the pelvic floor, fallopian tubes, intestines, vagina, or the uterus; the cysts will grow there. The most common organ however is the ovary. The discharge gets into the ovaries and releases blood. But there is no place for the blood to flow. This causes the blood to accumulate gradually and the cyst gets filled with it. If the blood stays in the cyst for a long time, it will appear brown and resemble chocolate. This is why it is also known as a chocolate cyst.
The endometrial tissue lines the uterus. In endometriosis, this tissue can grow outside the uterine wall. This tissue then attaches to other parts such as the ovaries, fallopian tubes, and also nearby organs such as the urinary bladder. This can lead to painful and heavy menses. In severe cases, the affected organs can also be damaged.
Various industry experts state that estrogen plays a key role in causing this condition. Genetics of course is an important factor for females to develop this condition.
Problems such as thyroid, PCOS, and regular intake of prescription fertility drugs can also cause fluctuations in progesterone and estrogen levels further leading to the chocolate cyst. Infections in the pelvic region that are left unattended can spread to neighbouring tissues and organs and further affect the ovaries.
Symptoms of Chocolate Cyst
The symptoms of a chocolate cyst are varied and some of them are similar to that of endometriosis. They include
- Painful periods
- Extreme pelvic pain during menses
- Pain during sex
- Digestive troubles
- Painful bowel movements
- Heavy menstrual flow
- Difficulty in conceiving
To diagnose the condition the right way, an ultrasound of the ovaries is essential. The tissue needs to be examined and in some cases, even the cyst will have to be removed for further analysis. A routine vaginal ultrasound or X-ray can help discover the cyst. A pelvic ultrasound may be advised during a routine pelvic examination. In certain cases, a needle biopsy may also be recommended wherein the liquid is extracted from the cyst and gauged under a microscope for further diagnosis.
Chocolate cyst affecting the fertility
Chocolate cysts attach to the ovaries and can significantly impact ovarian function. In certain cases, they even hamper the functioning of ovaries and prevent pregnancy. It thus impacts fertility and causes issues in conceiving. The endometrial growth triggers inflammation and due to this reason, it can be challenging for the fertilized egg to implant in the uterus. This inflammation can also affect the developing embryo. The cysts make it difficult for the ovaries to produce eggs. If ovulation occurs less frequently or the eggs are not healthy, the chance of pregnancy decreases. Various studies also highlight that removing cysts can damage the ovaries or deplete the egg reserve. This can further impact fertility. If large cysts rupture anytime, their content could enter the pelvic cavity and this can cause fertility blockages and pain. It can also impact the fallopian tube and this may pose a hindrance in the movement of the sperm as well as the egg. It can even interfere with the implantation process of a fertilized egg and this could significantly increase the risk of miscarriage.
Right treatment for chocolate cysts
The treatment for chocolate cyst depends on the age as well as the symptoms. It is also dependent on whether one or both ovaries are affected and your reproductive goals. Doctors may recommend removing the cyst if there are signs of infertility. If in case, a woman plans to undergo IVF, surgical cyst removal can make the process all the more challenging and the chances of pregnancy reduce significantly.
This is why no matter what the scenario is, it is always advisable to consult with a healthcare professional or a fertility specialist before narrowing down to the treatment process. Tell them clearly about the discomfort that you are facing and if you intend to plan a baby. This will help them in coming up with the appropriate line of treatment for you.
Summing up!
Endometriosis is one of the major reasons causing chocolate cysts. The cysts can develop in any of the female reproductive parts. However, ovaries are one of the commonly affected organs. The chocolate cyst can cause painful periods, pain during sex, and digestive issues. However, in severe cases, it can even affect fertility in females. It can obstruct the functioning of the ovaries and cause problems in females who are wanting to conceive. In fact, it even interferes in the implantation process and leads to miscarriages. If not treated timely, the situation can worsen and chocolate cysts could render a severe impact on the reproductive system as well as fertility. This is why routine tests and proper diagnosis is essential so that the chocolate cyst can be timely treated. If you are planning to start a family, then it becomes imperative that you seek medical supervision from a fertility expert so that they can treat the situation in the appropriate manner.
(This article is attributed to Dr Parul Aggarwal, Consultant - Reproductive Medicine, Milann Fertility Hospital)
(Disclaimer: The opinions expressed in this article are those of the author. They do not reflect the views of India TV)
