Ovarian Endometrioma
An ovarian endometrioma is a type of ovarian cyst formed when endometrial-like tissue—similar to the lining of the uterus—grows on or within the ovary. These cysts are filled with thick, old blood, giving them a characteristic “chocolate cyst” appearance. Endometriomas are commonly associated with endometriosis and may contribute to pelvic pain, painful periods, and infertility.
What is it?
An ovarian endometrioma forms when endometrial-like tissue bleeds over time within the ovary, leading to a cyst filled with dark, thick fluid. These cysts can vary in size and may distort normal ovarian structure. Endometriomas are a key feature of endometriosis, a condition where similar tissue grows outside the uterus and can cause chronic pain or fertility problems.
Ultrasound often shows a “ground-glass” appearance within the cyst, while MRI can confirm the presence of blood products and distinguish an endometrioma from other complex ovarian cysts. Imaging is crucial for identifying the cyst type and planning treatment if needed.
Important to Know
Endometriomas may remain stable or grow slowly. They can affect fertility and may recur even after treatment. Management depends on symptoms, cyst size, age, and fertility plans. Hormonal therapies may reduce pain, while surgery may be recommended for larger cysts or when fertility is a priority.
Red flag symptoms include sudden severe pelvic pain (which may indicate rupture or torsion), fever, worsening menstrual pain, or difficulty with bowel movements or urination. Follow-up imaging is often recommended to monitor cyst size or evaluate progression of endometriosis.