A health condition in which specific cysts filled with old blood appear, which is a sign of endometriosis, is called ovarian endometrioma. It often occurs when endometrial-like tissue travels outside the uterus. While these cysts may not cause any problems, some people may experience unpleasant symptoms. Doctors often recommend surgery to remove them.
However, endometriosis is a health condition in which tissue that is similar to the tissue that grows inside the uterus begins to grow outside it. Usually, it causes painful menstrual periods, pelvic pain, and may affect the ability to become pregnant. If this tissue attaches to an ovary, it causes an endometrioma. Sometimes, these cysts are called “chocolate cysts, and it may indicate a severe form of endometriosis.
Generally, about 10% of people who menstruate have endometriosis, and approximately 17% to 44% of them develop an ovarian endometrioma.
Symptoms
While pain and tenderness are the most common symptoms of an ovarian endometrioma, this condition may also cause other symptoms. Moreover, the following symptoms can occur at any time, not only when you are on your period. Check some examples below:
- Severe pain during menstrual periods
- Dyspareunia (pain during sexual activity)
- Urge to urinate more
- Back pain
- Bloating
- Nausea
- Vomiting
- Pain when you are pooping or peeing
In general, endometriomas can be very small, but in some cases, they can grow large enough to put pressure on one or both ovaries.
Causes and Risk Factors
Healthcare providers do not fully understand why this condition happens, but they think endometriosis occurs because of some tissue that is shed when menstrual flow goes backward (also known as retrograde menstruation). Normally, this tissue should leave the body through the vagina. Commonly, the tissue that does not leave the body may attach to the fallopian tubes and onto the ovaries and may thicken during each menstrual cycle. As a result, it causes inflammation and the formation of the endometrioma.
Moreover, doctors have identified some factors that may increase your risk of developing ovarian endometrioma. Check some risk factors below:
- A family history of endometriosis
- The age at which the first periods have started (people who begin menstruating before 11 may have an increased risk of an ovarian endometrioma)
- Length of the menstrual cycle (less than 27 days between periods) and the duration of flow (bleeding that occurs for more than 7 days)
- Abnormalities in the uterus or fallopian tubes
What Are The Potential Complications of Endometriomas?
Most of the time, ovarian endometriomas indicate a severe form of endometriosis. However, people with these cysts may also experience the following symptoms. Examples include:
- Infertility caused by scar tissue and inflammation of the ovaries or fallopian tubes
- Bladder and bowel issues (including frequent urination, a complete blockage, or chronic constipation)
- Endometrioma rupture – When the endometrioma grows large enough, it may open and begin to leak. As a result, you may experience additional pain.
- An increased risk of ovarian cancer
- Severe abdominal pain and weakness
- High fever
- Adhesions
- Ovarian torsion
The previous list does not contain a complete list of ovarian endometrioma complications. In any case, you can talk with your physician about measures to reduce the risk or even prevent them. Additionally, there is no way to prevent the formation of ovarian endometriomas.
Diagnosis
In most cases, the diagnosis of this condition begins with a physical examination and questions about your symptoms and medical history. During this examination, physicians will check for irregularities linked to the disease (such as a large ovarian endometrioma). However, to get more information, your doctor may perform a vaginal ultrasound or MRI (magnetic resonance imaging).
To confirm or rule out an ovarian endometrioma, doctors will perform a biopsy. During this test, they will remove a small amount of cyst for testing. They take this sample during a laparoscopy. Check below for other tests often used to rule out other conditions that cause similar symptoms:
- A complete blood count (CBC) – This is a type of blood test used to determine infection or low red blood cell count (anemia) that may indicate an ovarian endometrioma.
- Urine tests (also called urinalysis) – This test helps doctors diagnose urinary tract infections (UTIs).
- Sexually transmitted infection tests – Doctors often perform these tests to rule out a sexually transmitted infection that causes symptoms similar to an ovarian endometrioma.
Treatment
Unfortunately, it is not possible to cure this condition. That’s why the treatment goal is to relieve the symptoms, prevent serious complications (such as infertility), and improve your quality of life. Check below some treatments often recommended for people with ovarian endometriomas:
- Monitoring – If you have small cysts that do not cause symptoms, doctors may not recommend any treatment.
- Surgery – This option is recommended by doctors when the cyst is bigger than 4 centimeters. The removal of this cyst often helps prevent complications (such as rupture or infertility) and improve the symptoms.
- Medicines – The following options are often recommended by doctors to balance hormonal fluctuations that are caused by endometriosis. These include birth control pills, patches, vaginal rings, and over-the-counter medicines to ease pain.
Frequently Asked Questions
Can Ovarian Endometriomas Grow Back?
Yes, these cysts may return even after a successful treatment. However, it depends on the size of the original endometrioma, age, the type of treatment, and other factors. For more details, discuss it with your doctor.
When should I go to the ER?
It is recommended to call 911 or go to the nearest emergency room (ER) if any of the following symptoms occur. For example:
- Vomiting
- Fever
- Severe abdominal (belly) pain that occurs suddenly
- Weakness
- Dizziness
- Fainting
What is the difference between an ovarian cyst and an endometrioma?
The difference between these conditions is what is inside the cyst and the exact cause. For instance, an endometrioma contains old blood while an ovarian cyst has blood, tissue, and other types of clear, brown, or red fluid.
Is endometrioma worse than endometriosis?
In general, endometrioma is not necessarily worse than the other. Moreover, ovarian endometriomas are a type of endometriosis, but if you develop an endometrioma cyst, it may indicate a severe form of endometriosis. Ask your healthcare provider if you have additional questions.
