Patient's question:
Patient Age: I am currently 30 years old. At the age of 28, I underwent laparoscopic removal of a chocolate cyst of the ovary. [I originally had irregular periods due to an intrauterine device (IUD), sometimes coming every 20 days. Later, I had a gynecological IUD removal and uterine scraping surgery. One year after the surgery, I was found to have a chocolate cyst of the ovary]. More than a year after the cyst removal, it returned. During this year and a half, I have been taking Mirena birth control pills and my periods have been very regular. I do not experience dysmenorrhea or abdominal pain. The cyst was discovered during a gynecological examination. Now, what should I do?Doctor's answer:
Hello: The current treatment is best surgical treatment! Ovarian chocolate cyst is a "mass" but not a "tumor," it is a type of lesion of endometriosis. Under normal circumstances, the endometrium grows in the uterine cavity, influenced by the female hormones in the body, it sheds once a month, forming menstruation. If during menstruation, the shed endometrial fragments follow the menstrual blood to flow backward through the fallopian tubes into the pelvic cavity, they are implanted on the surface of the ovary or other pelvic locations, forming ectopic cysts. This ectopic endometrium is also influenced by sex hormones, and it 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 form a cyst containing old blood. This old blood is brown, viscous like paste, resembling chocolate, hence it is also called a "chocolate cyst." This cyst can gradually enlarge and sometimes rupture during menstruation or after menstruation, but it rarely undergoes malignancy.