Endometriosis / Chocolate Cysts

Symptoms of endometriosis include:

• Menstrual pain
• Chronic pelvic pain
• Pain during or after sex
• Excessive menstrual blood or irregular periods
• Painful urination and defecation
• Infertility
   

The cause of endometriosis has not yet been determined by the medical profession. One of the theories is that it is caused by the backflow of menstrual blood. During menstruation, menstrual blood accompanied by endometrial cells flows backwards into the pelvis, causing endometrial tissue to grow outside the uterus. The ectopic endometrium will also periodically thicken and shed, and bleed.
 

If the endometrial tissue is lodged in the ovaries, when the menstrual blood accumulates in the ovaries, the menstrual blood oxidises to a brownish colour similar to that of chocolate and forms a cyst, commonly known as a "chocolate tumour".

If the endometrial tissue grows in the muscular layer of the uterus, adenomyosis will form.

If the endometrial tissue grows in the abdominal cavity or on the surface of the peritoneum, it is prone to inflammation and pain. Continuous inflammation will cause scarring and adhesion between surrounding tissues and organs, and even affect the normal functioning of organs.

Risk groups for endometriosis include:

• Never been pregnant
• Have a family history of endometriosis.
• Having a menstrual cycle of less than 27 days
• Heavy menstrual flow that lasts more than 7 days
• Early menarche

The doctor will perform the following tests to help make a diagnosis:

• Pelvic examination
• Imaging tests, including ultrasound or MRI (to detect ovarian endometriomas, adhesions and deep nodules)
• Depending on the circumstances, the doctor may need to perform laparoscopic surgery and tissue sampling to help confirm the diagnosis.

Currently, there is no cure for endometriosis, but the main focus is on treating the symptoms. Depending on age, symptoms and the need to have children, it can be treated with medication or surgery.

The symptoms of endometriosis are so varied that it is not easy for the general public to recognise that they have the condition. Endometriosis can cause significant disruption to a person's life:

• Inability to go to work or school
• Affecting the sexual health of the patient and/or his/her partner.

In addition, many people delay treatment due to unawareness of symptoms (e.g. menstrual cramps), which further reduces their quality of life and may lead to infertility.

There is no known way to prevent endometriosis. However, the following measures are recommended to help diagnose endometriosis early and manage the progression of the disease:

• Women can undergo regular gynecologic check-ups
• Maintaining a healthy lifestyle, e.g. appropriate exercise, healthy diet, etc.
• Raise awareness of the condition and seek medical advice if you experience any symptoms that suggest endometriosis.

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^1.World Health Organization - endometriosis. Retrieved February 3, 2023, from https://www.who.int/zh/news-room/fact-sheets/detail/endometriosis

1. Endometriosis | WHO from https://www.who.int/news-room/fact-sheets/detail/endometriosis 
2. Endometriosis can lead to infertility | Medcom Limited from https://wp.3phk.com/news-01042019/   
3. Endometriosis | NIH from https://www.nichd.nih.gov/health/topics/endometri/conditioninfo 
4. Fibroids | NHS from https://www.nhs.uk/conditions/fibroids/  
5. Endometriosis | NHS from https://www.nhs.uk/conditions/endometriosis/