A Guide on Chocolate Cysts: Symptoms, Causes, and Treatment

You might have heard of polycystic ovaries, and you might be a chocolate lover, but did you know that some growths that can occur in women are known as chocolate cysts? While 20% of women develop at least one pelvic mass in their lifetime, not all are cysts. Chocolate cysts are one of the 30 types of ovarian masses that may affect a woman’s fertility and quality of life.

What is a Chocolate Cyst?

Chocolate cysts get their name from the brownish fluid filled in them. The growth of endometrial tissue in the regions outside the uterus may cause the formation of such growths. This makes the condition a subgroup of endometriosis. That is why such cysts are also called ovarian endometriomas. While ovarian masses may have cloudy or milky fluid or blood, the presence of old menstrual blood, endometrial tissue and inflammatory enzymes turns the colour brown, giving this type of tumour its name.

Who Can Get Chocolate Cysts?

About 8% of women of reproductive age and 18% in their postmenopausal stage develop chocolate cysts. While anyone who menstruates can develop the condition, women with endometriosis are at higher risk. About 30%-40% of endometriosis patients develop the condition. Most cysts are benign or non-cancerous. However, postmenopausal women have a higher risk of cysts turning malignant. Therefore, regular medical check-ups, learning about the symptoms of chocolate cysts and getting timely treatment are necessary. Delays in treatment or pregnancy may increase the risk of the growth rupturing or discharging its fluid contents into the abdominal cavity, creating several complications.

Poor lifestyle choices, such as lack of exercise, obesity, smoking and excessive alcohol consumption may also increase the risk of endometriosis and, hence, ovarian endometrioma. Oxidative stress also increases the risk of ovarian cysts. The condition may occur due to environmental factors, such as exposure to air pollutants and regular consumption of highly processed food and unhealthy fats.

In addition, delaying childbearing with the use of contraceptives can lead to high oestrogen levels in the body. This, in turn, may lead to the development of endometrial tissue outside the uterus, especially the ovaries, leading to ovarian cysts.

Causes of Chocolate Cysts

Chocolate cysts are categorised according to their size, which may vary from a few millimetres to several centimetres. Small cysts have a diametre of less than 4 cm, while medium ones may range from 4 cm to 8 cm in diametre. Cysts with a diametre of over 8 cm are considered large.

The causes of endometriosis are still under research. One of the most prominently accepted causes is menstruation in the retrograde direction, which leads the blood to the abdominal cavity rather than being eliminated via the cervix and vagina. This blood and accompanying tissues then get trapped in cysts. Other causes are immunity disorders, hormonal imbalances and genetic predisposition.

Symptoms of Chocolate Cysts

Some of the most common symptoms of ovarian endometrioma are:

• Very painful periods, the discomfort may even radiate to the lower back.
• Cyclic migraines, i.e., headaches occurring during a particular menstrual phase (follicular, ovulatory, luteal).
• Pain during intercourse.
• Difficulties in getting pregnant.

How Do Chocolate Cysts Affect Fertility in Women?

Adhesions or scarring left by chocolate cysts may interfere with the normal functioning of the ovaries or fallopian tubes. These may create difficulties in releasing or pushing the egg to the uterus, resulting in infertility. Deterioration in the quality of eggs, due to suboptimal ovarian function, may also reduce the chances of fertilisation.

Diagnosis of Chocolate Cysts

Your healthcare professional may take a multi-faceted approach to confirm the presence of ovarian endometrioma:

Medical History

Your menstrual regularity, experience during flow and intercourse, and family history of endometriosis.

Physical Examination

A pelvic exam can reveal the presence of any mass in the region, especially larger ones.

Imaging

Transvaginal ultrasound or MRI scans help determine the location and size of the cysts.

Laparoscopy

Visualising the cysts directly with a tiny camera inserted through the cervix and performing a biopsy on them, if necessary, can confirm their type.

Treatment for Chocolate Cysts

Depending on the severity of the condition, your doctor may advise one of the following treatments for chocolate cysts:

• Over-the-counter medication for chocolate cyst pain management.
• Hormonal therapy to reduce cyst growth and regularise menstrual cycles.
• Laparoscopic surgery to remove the cysts. In case of severe invasion, the removal of one or both ovaries may be necessary.

Additional procedures may be required if the cysts are large or have affected a significant part of the reproductive tract. When fertility is a concern, your fertility specialist may recommend fertility preservation processes, such as egg freezing.

While you might prefer the treatment of chocolate cysts without surgery, fertility specialists consider many factors before making a call. The type, position and number of cysts, your age, and factors such as other medical conditions, govern the course of treatment for chocolate cysts. Early diagnosis and expert fertility care can prevent the need for surgery. The specialist may also advise lifestyle changes for better chocolate cyst management.

Conclusion

Chocolate cysts are treatable, often non-surgically. The experienced specialists and cutting-edge technology at Oasis Fertility Clinics assure you of quality care and support. Visit an Oasis Fertility clinic near you for expert diagnosis and treatment. You can also speak to our experts via live chat or call 1800-3001-1000 for immediate assistance.

FAQs on Chocolate Cysts

Can I get pregnant with a chocolate cyst?

Yes, you can get pregnant with a chocolate cyst, but it might make things a bit more difficult. These cysts can sometimes affect how your ovaries and fallopian tubes work, which may lead to fertility problems. They can cause scarring or blockages that make it harder for an egg to reach the uterus. Also, the quality of eggs can be affected, making fertilization trickier. The good news is that with early diagnosis and proper care, your chances of getting pregnant can improve.

Can chocolate cysts be cancerous?

Most chocolate cysts aren’t cancerous, so there’s no need to worry too much. However, for women who are postmenopausal, the risk of these cysts turning cancerous is slightly higher. That’s why it’s important to keep an eye on them with regular check-ups, especially as you get older. Early detection and proper care can help prevent any serious issues.

What size chocolate cyst requires surgery?

Whether or not you need surgery depends on the size and how much trouble the cyst is causing. Chocolate cysts larger than 4 cm might need to be monitored, and those over 8 cm are generally considered large enough for doctors to recommend surgery. Your doctor will also take into account your symptoms, age, and whether you’re trying to get pregnant before deciding if surgery is the right option.

How to shrink chocolate cysts naturally?

While there’s no surefire way to shrink chocolate cysts naturally, certain lifestyle changes can help manage them. Staying active, maintaining a healthy weight, and eating a diet full of antioxidants might help. Try to avoid processed foods, unhealthy fats, smoking, and excessive alcohol. These changes can contribute to your overall well-being, which may help with cyst management. It’s always best to check with your doctor before trying any natural approaches.