Did you know?
Endometriomas, otherwise known as “chocolate cysts” are, sadly, not made of chocolate.
Endometriomas
Researched by:
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Karen Pendergrass
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Karen Pendergrass
Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.
Fact-checked by:
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Kimberly Eyer
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Kimberly Eyer
Kimberly Eyer, a Registered Nurse with 30 years of nursing experience across diverse settings, including Home Health, ICU, Operating Room Nursing, and Research. Her roles have encompassed Operating Room Nurse, RN First Assistant, and Acting Director of a Same Day Surgery Center. Her specialty areas include Adult Cardiac Surgery, Congenital Cardiac Surgery, Vascular Surgery, and Neurosurgery.
An endometrioma is a type of ovarian cyst filled with old blood, arising from endometrial tissue outside the uterus, typically causing pain and potentially impacting fertility.
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Karen Pendergrass
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Kimberly Eyer
Researched by:
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Karen Pendergrass
ID
Karen Pendergrass
Fact-checked by:
-
Kimberly Eyer
ID
Kimberly Eyer
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Karen Pendergrass
Overview Overview
Endometriomas, also known as “chocolate cysts” due to their dark, chocolate-like content, are ovarian cysts arising from endometriosis. This condition involves ectopic endometrial tissue growing outside the uterus, often causing pain and fertility issues. When this tissue forms cysts filled with degraded, dark brown blood on an ovary, it indicates a severe stage of endometriosis. Unlike typical hematomas occurring during ovulation, endometriomas are unique. They have sticky endometrial stroma and glands and contain more fibrous tissue. This composition makes them likely to form adhesions in surrounding tissues, causing significant pain and complicating their surgical removal. Endometriomas can lead to chronic pelvic pain and infertility, frequently necessitating surgical treatment. Their distinct appearance comes from internal bleeding and accumulated blood within the cysts.
Pathophysiology
The origins of endometriomas are deeply connected to the broader condition of endometriosis, a topic still debated in the medical community. The most accepted theory, retrograde menstruation, suggests that endometrial tissue backs up through the fallopian tubes into the pelvis during menstruation, where it implants and grows. This process can result in endometriosis lesions, some developing into endometriomas on the ovaries. However, endometriosis likely arises from multiple factors, not just retrograde menstruation. This complexity is evident in cases of distant endometriosis sites or in pre-pubescent females. Other proposed theories include coelomic metaplasia theory, and lymphatic metaplasia theory. The true pathogenesis likely involves a combination of these factors, illustrating the disease’s complex nature.
Symptoms
While some individuals may not experience symptoms, others may suffer from pain, particularly during menstruation or sexual intercourse. Endometriomas can also contribute to infertility by affecting the ovaries’ function and the quality of nearby eggs. Additionally, their presence might signal a wider spread of endometriosis within the pelvis, potentially leading to complications like adhesions and chronic pelvic pain.
Risk Factors
Endometriomas have limited data concerning their unique risk factors. However, well-documented general risk factors for developing endometriosis may indirectly increase the likelihood of developing endometriomas. These factors may contribute to the pathogenesis of endometriosis and, by extension, could influence the development of endometriomas.
What other risk factors are associated with endometriomas?
| Risk Factor | Details |
|---|---|
| Nulliparity | Higher risk associated with never having given birth |
| Early menarche | Onset typically before 11 to 13 years old |
| Late menopause | Along with short menstrual cycles (less than 27 days) |
| Heavy menstrual bleeding | Noted as a significant risk factor |
| Mullerian anomalies | Developmental abnormalities in the female reproductive tract |
| Height | Greater than 68 inches |
| Low BMI | Lower body mass index noted as a risk factor |
| High trans fat consumption | Eating large amounts of trans-unsaturated fats |
| Exposure to diethylstilbestrol | Exposure in utero to this synthetic estrogen |
Chronic Pelvic Pain (CPP)
Chronic Pelvic Pain (CPP) is persistent pain in the pelvic region lasting six months or longer, often multifactorial, impacting physical and emotional well-being, and associated with various medical conditions.
Infertility
Infertility is the inability to conceive after 12 months of regular, unprotected sex. It affects both men and women and can be due to various physical, hormonal, or genetic factors. Treatments include medication, surgery, assisted reproductive technologies, and lifestyle changes.
Retrograde Menstruation Theory
Retrograde menstruation theory holds that during menstruation, some endometrial tissue reverses through the fallopian tubes into the pelvic cavity. It implants on pelvic organs, thickens, breaks down, and bleeds cyclically, causing inflammation, pain, and scar tissue, characteristic of endometriosis.
Coelomic Metaplasia Theory
Coelomic Metaplasia Theory could help explain the cases of endometriosis in men or in women who are not yet menstruating.
Lymphovascular Metastasis Theory
Lymphovascular Metastasis Theory posits that endometrial cells spread via blood and lymph systems, causing distant endometriosis. Evidence is promising but limited.