Endometriosis (Chocolate Cyst)

What is Endometriosis (Chocolate Cyst)?

Endometriosis, also known as chocolate cyst, is a mostly painful condition that occurs as a result of the development of the endometrium layer covering the cervix at another point outside the uterus. Endometriosis is the most common disease;

In the ovaries,

in the fallopian tubes

It is found in the tissue that covers the pelvis.

Endometriosis is one of the most common diseases in women and one of the most difficult to diagnose. It is known that the disease is encountered and spreads in approximately one out of every ten women. Although it is a common disorder that affects an average of 176 million women in the reproductive period in the world, its recognition is very low. The condition can affect women of almost any age, but is most common in women in their 30s and 40s.

What are the Causes of Endometriosis?

The root cause of the disease is not known with certainty. However, there are some theories put forward for this. We can examine these theories under the following headings:

Genetic Factors

The disorder tends to be passed on to the family through genes. It even affects certain ethnic groups more than other ethnic groups. If there is a person with endometriosis in the first degree relative (family) of the individual, the probability of the disease being seen in this person is higher than in the normal population.

Presence of Menstruation in the Reverse Direction

With the menstrual bleeding, the endometrium tissue covering the uterus is expelled from the body through the vagina. However, if there is a problem of backward bleeding, this tissue starts from the fallopian tubes and flows into the stomach cavity. Thus, it settles in the organs located here and causes endometriosis.

Immune System Issues

Due to problems in the immune system, the development of endometriosis in the body is possible.

Blood circulation or lymphatic system

The spread of endometrial cells to different parts of the body through the blood circulation or the lymphatic system, which is a part of the immune system, can also trigger this disease.

However, it should be noted that none of these theories can definitively explain why endometriosis occurs.

What Are the Symptoms of Endometriosis?

Endometriosis can progress without showing any symptoms in some people. However, it can cause severe pain and similar complaints in some patients. It can be seen as a chocolate cyst in the ovaries or as a nodular lesion in the intestines on the membranes covering the intestine or in the back of the uterus during a regular control of the patient.

Common chocolate cyst symptoms can be examined under the following headings:

Chronic Fatigue

Chronic fatigue, which is one of the rarest symptoms seen in people with endometriosis, causes a constant feeling of fatigue and problems focusing. However, just in case, it is important to pay attention to spring fatigue, which can last for a long time, and to evaluate the possibility of endometriosis.

Waist, Back, Abdominal, Groin Pain

Among the most common complaints in people with the disease are low back and back pain. It is often unknown that the treatment of this type of pain is available to obstetricians. The basis of these long-lasting pains may be a chocolate cyst. When people notice this ailment and consult a doctor for treatment, their general complaints include being away from social activities, often feeling sluggish and tired.

Not wanting to go to the toilet

In cases where the chocolate cyst, which has spread to the intestines, narrows the intestine, severe pain may occur during toileting. Apart from this, it can cause problems in the organs located in the pelvis (pelvis).

In such cases, defecation and refusal to urinate are among the most common complaints. Severe pain and burning may occur during urination. The main reason for this is that the organs are very close to each other. The movement of any organ affects the lesion at the other point and causes burning and pain.

Infertility

It is often discussed whether there is a relationship between infertility, that is, infertility and endometriosis. Endometriosis can cause obstructions and adhesions, especially in the tubes and ovaries. This can also cause infertility. In addition, this discomfort may occur when some couples consult a doctor to want to have a child.

Painful Sexual Intercourse

Many women who feel pain during sexual intercourse do not suspect the existence of a gynecological disorder underlying this problem. This situation can cause various problems between couples. Some of these problems can lead to serious problems, up to cooling and separation. For this reason, it may be useful to consider the chocolate cyst in such problems.

Severe menstrual cramps

Severe menstrual pain is the most prominent symptom that is commonly encountered in almost every woman and can be counted among the symptoms of chocolate cyst depending on the severity of the pain. Although women mostly think that there is no need to worry about these pains and that many women have the same problem, this problem is shown as the most obvious symptom by gynecologists.

Gas and Bloating in the Stomach

Another symptom of the discomfort is pain and bloating in the stomach. The patient complains of this uncomfortable swelling in the abdomen, especially during the menstrual period. There may be other problems underlying this swelling, and the danger of endometriosis is always present.

Depression

Another common symptom of the disorder is depression. Chronic depression, which may be a result of the problems caused by the disease;

Disruptions in daily life,

Sexual aversions,

Other sexual problems

It progresses to chronic fatigue and thus to the inability to enjoy life.

Individuals with the above symptoms should definitely consult a doctor, as the cause of their symptoms may also be caused by other events.

What Are the Stages of Endometriosis?

The ASRM, known as the American Society for Reproductive Medicine, has created a classification system for endometriosis, or chocolate cyst. Stage of endometriosis;

to its region,

to the amount,

to the depth,

It may vary depending on the size of the implants of the intrauterine tissue.

Some of the specific criteria are as follows:

Spread rate of diseased tissue

Relationship of female internal organs (tubes and ovaries) with discomfort

The rate of adhesions in female internal organs

Affect rate of fallopian tubes

Who is at Risk for Endometriosis?

Any woman can have endometriosis. However, some factors are also in the important risk group for the development of the disease in women;

1st degree relatives have this disease

Individuals who will give birth for the first time after the age of 30

white skinned women

Individuals with abnormal uterine structure

Individuals who have never given birth

Individuals who see menstruation at an early age

Individuals who enter menopause at a late age

People who have a higher level of estrogen in their body or whose body is more exposed to estrogen produced throughout their life

Individuals with a low body mass index

Individuals who consume alcohol

Having one or more relatives with endometriosis

Any problem that prevents the normal excretion of menstrual blood from the body

Abnormalities in the uterus

What are the Endometriosis Treatment Methods?

Chocolate cyst treatment is mostly done with drugs and surgery. The endometriosis treatment method to be determined by the patient and the doctor may vary depending on the severity of the symptoms and the desire of the person to be pregnant. Often, physicians recommend conservative treatment methods first and perform surgery as a last resort. The physician may recommend some drugs with pain-relieving properties to contribute to the relief of the patient's pain. If the drugs taken are insufficient to reduce the pain at the maximum dose, it may be necessary to try a different method to keep the symptoms under control.

Hormone Treatment

Hormone supplements can give positive results in relieving pain caused by endometriosis in some cases. During the menstrual cycle, the ups and downs of hormones cause the intrauterine tissues outside the uterus to thicken and then dissolve and bleed. Thanks to hormone therapy, the development of endometrial tissue can be slowed down and the formation of new foci can be prevented.

However, hormone therapy is not a definitive treatment for endometriosis. It is possible for symptoms to recur after you stop treatment. Hormone therapies used in the treatment of endometriosis are as follows;

Birth Control Pills, Tapes and Vaginal Rings

This method ensures that the hormones that cause the endometrial tissue to accumulate continuously are kept under control. These techniques contribute to the relief of mild to moderate pain caused by endometriosis.

Progesterone Treatment

A cervical device, birth control injection or pill-like progesterone treatment can prevent menstrual bleeding and the development of endometrial foci. Thus, the pain and symptoms caused by endometriosis can be reduced.

Endometriosis Surgery

If you have endometriosis and you want to get pregnant, you can increase your chances of getting pregnant by treating your uterus and ovaries without damaging your uterus and ovaries with surgical operations that eliminate the disease.

Conservative Surgery

If you suffer from severe pain caused by the disease, surgery may be helpful. However, postoperative pain can still recur. Your doctor can start this operation laparoscopically or with an open operation for different conditions. In laparoscopic surgery, the specialist surgeon puts a visual device called laparoscope, which passes through the belly button with the help of a thin incision into the stomach cavity. Thus, it completes the treatment by removing the endometrial tissues from another small incision.

Hysterectomy

In severe cases, the last option is total hysterectomy. This operation is the best method to completely destroy the uterus, cervix and ovaries. However, hysterectomy operation, in which only the uterus is removed, may be ineffective because the ovaries still present in the body can trigger endometriosis tissue by producing estrogen. Thus, it can cause the pain to recur.

Hysterectomy is often seen as a last option for women who are in their fertile period. The reason for this is that the possibility of pregnancy after hysterectomy is eliminated. It is very important to act together with a trusted physician in the treatment of chocolate cyst. It may be helpful to get another opinion before treatment, to know all your options and to make sure the best course is chosen.