Prof. Dr. Umit Inceboz answered our questions on chocolate cysts (endometriomas). She is an out standing doctor on this topic and also an executive member of Turkish Endometriosis and Adenomyosis Society. “Never ignore, call your doctor” she cautions.

Chocolate cysts (endometriomas) are benign cysts that may cause severe pain and even infertility. They precipitate long painful years. Their pain can mix up with menstrual pain since the endometriomas are located on the ovaries. “To see a gynecologist necessary, the treatment can differ for each patient.” says Prof.Dr.Umit Inceboz.

What is a chocolate cyst?

“We doctors also wish that it was as pretty as it sounds. Unfortunately that is not the case. Chocolate cyst is having the endometrium lining cells on the ovaries, forming saccules (called cyst) and bleeds during menstruation inside the cyst and forms the consistency and the colour of chocolate.” 

In what age do we see endometiriomas?

“As our knowledge on chocolate cysts increase, our believes tend to change. Usually it is a disease for the reproductive age, but it can also be seen in adolescents and post menopausal women.

What are the similarities and differences of chocolate cyst pain and menstruation pain?

Endometriomas cause pain similar to menstruation (period) pain but usually do not respond to painkillers. Since pain is a common feature in both cases, it does not show whether there is an endometrioma or not. We recommend our patients who have severe menstruation pain, specially which does not decrease by pain killers, to see their doctor. 

Do chocolate cysts cure on its own over the years?

According to our knowledge we have at the moment, we believe that endometriomas do not cure on their own and patients need to seek treatment. Even though it is an estrogen dependent disease, it is expected to regress after menopoz though we also can see some cases where they even continue to grow.

Is surgery the effective cure for endometriomas?

It is not possible to talk about a treatment modality which will eliminate endometriomas for good. What we do right now is to suppress the cyst and restrain its growth by medical treatment, and remove the cyst by surgical treatment. Even if the surgical techniques are carried out with great attention, relapse rate is almost 50%.

Prof. Dr. Umit Inceboz,

Turkish Endometriosis & Adenomyosis Society Executive Member