What causes chocolate cysts?

The lining of these cysts acts much the way the lining of the uterus does. It grows and is then shed in response to the monthly rise and fall of female hormones.Instead of leaving the body, this tissue becomes trapped within the cavity of the cyst. Here it can produce inflammation and disrupt the ovaries.

• they feel a cyst during a pelvic exam
• they suspect you have endometriosis based on your symptoms
• you’re experiencing unexplained infertility

An ultrasound can identify if a cyst is present. But it can’t necessarily determine what type of cyst it is.To definitively diagnose a chocolate cyst, your doctor will extract fluid and debris from inside the cyst. This is usually done with a needle biopsy.During a needle biopsy, your doctor will use ultrasound to help them insert a needle through the vagina into the ovarian cyst. The extracted fluid is then examined under a microscope. Your doctor can diagnose the type of cyst using the results from the needle biopsy.

Treatment will depend on several factors, including:

• your age
• your symptoms
• whether one or both ovaries are affected
• whether or not you want to have children

If the cyst is small and not producing symptoms, your doctor may advise a watch-and-wait approach. They may also recommend medication that inhibits ovulation, such as the birth control pill. This can help control pain and slow the growth of cysts, but it can’t cure them.

Surgery to remove the cysts, called an ovarian cystectomy, is often recommended for women who have:

• painful symptoms
• cysts larger than 4 cm
• cysts that may be cancerous (but a 2006 review estimates less than 1 percent of cysts are cancerous)
• infertility

The surgery is generally done via a laparoscope. A laparoscope is a thin, long tube with a light and camera on the end that help doctors perform the procedure. It’s inserted through a small incision.