What is a chocolate cyst? Do I need to remove it?

Chocolate cyst TTC

What is it?
A chocolate Cyst, also known as Endometrioma, is an endometriosis that occurs in the ovaries. Endometrioma is a common gynecological disease. Simply put, the endometrial tissue that should be inside the uterus is growing in other areas, such as the ovaries, fallopian tubes, and near the uterus.

During the monthly menstrual visit, these areas also bleed with the menstrual cycle, but the menstrual blood can’t flow off, so it accumulates in the cysts. Since the latter are filled with old blood over the years, the blood has a chocolate-like appearance, which is why they are called "chocolate cysts".

How to treat chocolate cysts?
Chocolate cysts are not necessarily uncomfortable, but when they begin to grow, symptoms such as menstrual pain or disorders, pelvic pain, painful sexual activity, difficulty while urinating, and even infertility may occur.

Currently, there are two common treatments: medication and surgery. Medication includes oral contraceptives, luteinizing agents, and drugs containing androgens. For cysts smaller than 4 centimeters, medication with regular follow-up checks is usually sufficient. However, for cysts over 4 centimeters, most doctors will recommend surgical treatment depending on the situation.

Understandably, many women have reservations and worries about surgery and choose to wait, expecting the cyst to go away naturally. However, inaction often ends up making things worse. Thus, it’s recommended to consult a doctor as soon as possible and let him/her make a professional judgment.

According to a study, the success rate of a pregnancy can be increased by 20-60% after the surgery, so early check-ups are crucial if you are in your childbearing age.

To further address the importance of regular check-ups, we have a true story from our Eveline user:

Eveline user Emily shares her experience with Chocolate cysts
Ever since we got married, we have been planning our next step to add to our little family. I was over 35 years old, and although I was very anxious about getting pregnant, I still didn't want to go to a clinic. A friend then managed to persuade me to make an appointment for a routine gynecological examination.

On the day of my appointment, the doctor performed a chest palpation followed by an ultrasound of the vagina. The doctor looked at the screen and asked me, "Is this your first time seeing a gynecologist, or did you know you had a chocolate cyst before?”

I used to have annual pap smears and gynecological checkups, but in recent years, for various reasons, I haven't had regular checkups anymore. I knew I had a chocolate cyst two or three years ago, but my doctor back then said I didn't need surgery yet and regular follow-up visits would be enough.

Surgical removal of my chocolate cyst
This time, the doctor immediately felt that something was wrong and asked me to come back after my next period to check if it was a premenstrual symptom or if the chocolate cyst had gotten bigger. I went to the clinic again with anxiety, and the doctor confirmed it and said categorically, "Let's schedule the surgery right away, the cyst is quite big already and may affect the chance of conception if it is not treated.”

Luckily, I was able to schedule the surgery very quickly. Not only did the surgery remove the chocolate cyst, but the doctor also used contrast to check if my fallopian tubes were open during the surgery.

Even though the chance of the chocolate cyst becoming diseased is low, there was a possibility that the cyst could rupture because it was too large. For someone like me who is currently trying to get pregnant, the chocolate cysts may hinder the egg's ability to fertilize, embryo implantation, etc.

During the time of pregnancy preparation, it seems that God has heard my prayers and a little angel has recommended the Eveline OPK to me. Experienced women might know that it’s sometimes difficult to read the results of a traditional ovulation test.

Eveline, however, combines test strips with smartphones to analyze the ovulation test results, so you don't have to guess about interpreting them any longer. You can just rely on the Eveline app to know: Is it my “peak time” today?

Continuing our TTC journey
After the surgical removal of my chocolate cyst, my doctor informed us that the 6 months after the surgery mark a golden conception period and that we should regularly try to conceive.

We are now in our second month of TTC, and we are still waiting for good news. Sometimes even my husband reminds me now to take the test on the estimated ovulation date.

I would also like to encourage other women not to avoid their annual routine health checkups. Although not facing the problem makes life seem easier for a while, once we lose our health, we can't get it back.

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This article is for informational purposes only and is not meant to offer medical advice. 

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Photo by Andrea Piacquadio from Pexels

 

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