Endometrioma

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Endometrioma
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Pelvic pain, dysmenorrhea, dyspareunia, infertility
Complications	Ovarian torsion, rupture, infertility
Onset	Reproductive age
Duration	Chronic
Types	N/A
Causes	Endometriosis
Risks	Family history, early menarche, short menstrual cycles
Diagnosis	Ultrasound, MRI, Laparoscopy
Differential diagnosis	Ovarian cyst, hemorrhagic cyst, teratoma
Prevention	None
Treatment	Surgical excision, hormonal therapy
Medication	Oral contraceptives, GnRH agonists
Prognosis	Variable, depends on severity and treatment
Frequency	Common in women with endometriosis
Deaths	N/A

An endometrioma is a type of ovarian cyst formed when endometrial tissue grows in the ovaries. This condition is a manifestation of endometriosis, a disorder where tissue similar to the lining inside the uterus grows outside the uterus. Endometriomas are sometimes referred to as "chocolate cysts" due to the thick, brown, tar-like fluid they contain.

Pathophysiology

Endometriomas develop when endometrial tissue implants on the surface of the ovary and forms a cyst. The cysts are filled with old blood and can vary in size. The presence of endometriomas is associated with chronic pelvic pain, dysmenorrhea, and infertility. The exact mechanism by which endometriomas form is not fully understood, but it is believed to involve retrograde menstruation, coelomic metaplasia, and immune system dysfunction.

Symptoms

The symptoms of endometriomas can vary, but they often include:

• Chronic pelvic pain
• Painful periods (dysmenorrhea)
• Pain during intercourse (dyspareunia)
• Infertility
• Abdominal bloating

Some women with endometriomas may be asymptomatic and only discover the condition during an evaluation for infertility or during a routine pelvic examination.

Diagnosis

Perforierte Endometriosezyste

The diagnosis of endometriomas typically involves a combination of clinical evaluation, imaging studies, and sometimes surgical intervention. Ultrasound is the most common imaging modality used to identify endometriomas, which often appear as cystic masses with low-level internal echoes. Magnetic resonance imaging (MRI) can also be used to provide more detailed information. In some cases, a definitive diagnosis is made through laparoscopy, a minimally invasive surgical procedure that allows direct visualization of the ovaries and other pelvic structures.

Treatment

The treatment of endometriomas depends on the severity of symptoms, the size of the cysts, and the patient's desire for future fertility. Options include:

• Medical management: Hormonal therapies, such as oral contraceptives, gonadotropin-releasing hormone (GnRH) agonists, and progestins, can help manage symptoms and reduce the size of endometriomas.
• Surgical intervention: Laparoscopic surgery can be performed to remove endometriomas, especially in cases of severe pain or infertility. Surgical removal can improve fertility outcomes but may also reduce ovarian reserve.
• Pain management: Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to alleviate pain associated with endometriomas.

Prognosis

The prognosis for women with endometriomas varies. While surgical removal can provide relief from symptoms and improve fertility, there is a risk of recurrence. Long-term management often involves a combination of medical therapy and lifestyle modifications to manage symptoms and prevent recurrence.

See also

• Endometriosis
• Ovarian cyst
• Infertility
• Laparoscopy