Endometrial cysts are one of the symptoms of a disease called endometriosis. As a result of displacement and implantation of fragments of the endometrium into the ovarian tissue, cysts of various sizes, filled with a thick, tractable secretion of brown or black colour, are formed, which is why they are often called "chocolate" cysts.

During the menstrual cycle, the implanted endometrium undergoes the same hormonal changes as in the uterus. During menstruation, it begins to exfoliate and bleed. As the blood does not drain properly and accumulates to form clots, cysts filled with menstrual blood develop. Endometrial cysts often coexist with infertility and are usually only diagnosed during routine diagnostic tests performed to determine the cause of difficulties getting pregnant. They can also be the cause of chronic pelvic pain, which is the first and sometimes only symptom of the cyst.

If left untreated, they can enlarge significantly and the cystic capsule can rupture and spill its contents into the abdominal cavity, with the risk of infection, internal bleeding and even death. After rupture, the endometrium may implant in other internal organs and spread the disease. Often, especially in the early stages, cysts are not accompanied by any symptoms, but sometimes there may be complaints typical of endometriosis such as painful, heavy, prolonged periods, painful intercourse, pain during urination and bowel movements and others.

If you experience sudden severe lower abdominal pain, accompanied by fainting, vomiting or others, consult your doctor immediately. This may be a symptom of cyst rupture or torsion, which is seriously life-threatening. Endometrial cysts require pharmacological treatment or surgical removal. The management depends on the severity of the disease, the size of the cyst, the patient's general condition and her procreative plans.

They are easily diagnosed by internal examination, usg or MRI. A test to determine the level of the Ca-125 marker is also often recommended (preferably during the menstrual period), an elevated result of which can be an indication to help differentiate the type of cyst, but the diagnosis can only be made with certainty by histopathological examination of the contents of the fluid or a fragment of the lesion taken during surgery.

Conservative treatment of endometrial cysts can only be carried out by a doctor, with appropriately selected medication, according to a strictly defined schedule. It consists of treatment with prescription-only hormonal drugs. Most commonly, these are contraceptive drugs used in a continuous regimen, without 7-day breaks. This is to avoid bleeding and thus the enlargement of the cyst.