Patient's question:
What are the reasons that can lead to chocolate cysts in gynecological diseases?Doctor's answer:
Hello: Ovarian chocolate cyst is a "mass" but not a "tumor"; it is a type of lesion caused by endometriosis. Under normal circumstances, the endometrium grows inside the uterine cavity and, under the influence of female hormones in the body, sheds once a month, forming menstruation. If during menstruation, the shed endometrial fragments follow the menstrual blood back through the fallopian tubes into the pelvic cavity and implant on the surface of the ovaries or other pelvic areas, forming ectopic cysts, this ectopic endometrium is also influenced by sex hormones and sheds and bleeds repeatedly with the menstrual cycle. If the lesion occurs on the ovary, there is local bleeding during each menstrual period, causing the ovary to enlarge and forming a cyst containing old blood. This old blood is brown, viscous, and resembles a paste, hence the name "chocolate cyst." This cyst can gradually enlarge and sometimes rupture during or after menstruation, but it rarely becomes malignant.The main symptoms of endometriosis are dysmenorrhea, which is characterized by progressive dysmenorrhea that is secondary and progressively worsens. Secondary symptoms include infertility, menstrual disorders, and dyspareunia. The main causes of its onset are related to childbirth, multiple miscarriages, etc. Postpartum shed endometrium can implant in the cervix, vagina, and pelvic cavity, while repeated artificial abortions, through negative pressure aspiration, can also lead to pelvic implantation. Additionally, certain minor gynecological procedures, such as tubal patency tests, tubal irrigation, hysterosalpingography with iodine, cervical electrocautery, or cryotherapy, may allow shed endometrium to implant during the menstrual period, potentially leading to the development of endometriosis later on.