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Endometriosis (Chocolate Cyst)
Everything you need to know about endometriosis: Symptoms, diagnostic methods, treatment options, and quality of life recommendations.
10%
Prevalence in women
7-10 years
Average diagnosis time
176M
Women affected worldwide
Important Information
Endometriosis is a chronic condition, and early diagnosis can significantly impact your quality of life. If you suspect any symptoms, be sure to consult a gynecologist or obstetrician.
What is Endometriosis?
Endometriosis is a condition where the tissue that normally lines the inside of the uterus (endometrium) grows outside the uterus. This tissue most commonly occurs in the ovaries, fallopian tubes, intestines, and bladder.
This tissue, like the tissue inside the uterus, is affected by hormones every month; it thickens and tends to bleed. However, since it cannot be expelled from the body, it can gradually lead to inflammation, severe pain, adhesions between organs, and especially chocolate cysts seen in the ovaries.
Endometriosis affects approximately 1 in 10 women of reproductive age (176 million). Unfortunately, because symptoms can resemble menstrual pain, diagnosis often takes 7-10 years.
Early diagnosis and proper treatment help reduce pain and significantly improve the quality of life for patients.
Affected Areas
- Ovaries (Most common)
- Fallopian tubes
- Pelvic peritoneum
- Intestines and bladder
Risk Groups
- Women aged 25-35
- Family history of endometriosis
- Women who have never given birth
- Early menarche (under 12 years old)
Symptoms and Signs
While some women experience severe pain and other complaints, others may have mild symptoms or may not notice them at all. Therefore, not every woman with endometriosis experiences the same symptoms.
Painful Menstruation (Dysmenorrhea)
Severe pelvic and abdominal pain during menstruation
Pelvic Pain
Chronic pelvic pain that can also occur outside of menstruation.
Pain During Sexual Intercourse
Pain during or after sexual intercourse
Severe Cramps and Pain
Severe menstrual cramps and cramps that make daily life difficult.
Irregular Menstrual Cycle
Heavy or irregular menstrual bleeding.
Bowel Issues
Pain during bowel movements or urination
Digestive Complaints
Bloating, constipation, or diarrhea and other digestive system issues
Infertility
Difficulty getting pregnant (infertility)
Note: The severity of symptoms may not be proportional to the stage of the disease. Even minimal endometriosis can cause severe pain.
Disease Stages
According to the American Society for Reproductive Medicine (ASRM) classification, endometriosis is divided into 4 stages:
Minimal
Small lesions or wounds, superficial implants
Mild
More lesions, deeper implants
Moderate
Many deep implants, small cysts, adhesions
Severe
Many deep implants, large cysts (chocolate cysts), intense adhesions
Treatment Options
Endometriosis treatment is personalized based on the patient's age, symptom severity, disease stage, and fertility plans.
Medical Treatment
- Painkillers: For mild pain.
- Hormonal Treatments: Birth control pills, GnRH agonists.
- IUD (Intrauterine Device): Hormonal IUD.
Surgical Treatment
- Laparoscopy: The gold standard for minimally invasive surgery.
- Laparotomy: Open surgery for advanced stages.
- Hysterectomy: Removal of the uterus (rare).
Supportive Treatments
- Physical Therapy: Pelvic floor exercises.
- Dietary Support: Anti-inflammatory diet.
- Psychological Support: Pain management.
Frequently Asked Questions
Endometriosis (Chocolate Cyst) The most frequently asked questions and answers about
Endometriosis is a condition where cells similar to the tissue that normally lines the inside of the uterus are found outside the uterus (most commonly within the pelvis). It is not cancer and is not a contagious (infectious) disease. It can be commonly seen in women of reproductive age and may affect daily life at various levels as a long-term condition.
The most common complaints may include pelvic pain, painful menstrual periods, and sometimes irregular/heavy bleeding. Some individuals may experience pain during or after sexual intercourse and difficulties with conception. Pain radiating to the bowel, bladder, lower back, or upper legs, along with long-term fatigue, may also accompany the condition; however, some individuals may have no symptoms at all.
In diagnosing endometriosis, your doctor will first listen carefully to your complaints. The relationship between the pain and menstrual cycles is particularly assessed. If deemed necessary, a gynecological examination may be performed.
The most commonly used imaging method to aid in diagnosis is pelvic (vaginal) ultrasound. In some cases, MRI may be requested for a more detailed examination.
When a definitive diagnosis is needed, laparoscopy, a minimally invasive surgical method, may be recommended. During this procedure, a biopsy of suspicious tissue can be taken, and in suitable cases, treatment can also be performed in the same session.
Treatment plan;
- The severity of pain,
- The extent of the disease,
- The patient's age and desire for children
will be determined individually. Treatment options may include painkillers, hormonal therapies, and, if necessary, surgical options.
For patients planning to have children, fertility-related options will also be evaluated.
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