What are chocolate cysts and how do they relate to endometriosis?

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Bindi Irwin recently shared an emotional post on Instagram about her recovery after 13 years of suffering with endometriosis.

In the post, the wildlife conservationist, 27, listed all the things a doctor surgically removed to provide relief.

“Fifty-one endometriosis lesions, a chocolate cyst and my appendix were all removed,” she revealed.

BINDI IRWIN’S PAINFUL MEDICAL JOURNEY ENDS WITH LIFE-CHANGING SURGERIES

What is a chocolate cyst?

While not a widely known term, a “chocolate cyst” is a symptom of a more severe version of endometriosis, a condition in which tissues similar to those that line the uterus grow outside the organ, according to Cleveland Clinic. 

Bindi Irwin hospitalized - split

Bindi Irwin recently shared an emotional post on Instagram about her recovery after 13 years of suffering with endometriosis. (Bindi Irwin Instagram, Getty Images)

In addition to causing painful periods and pelvic discomfort, endometriosis can also impact fertility.

When the tissue attaches to an ovary, it’s called an endometrioma, Cleveland Clinic states.

The tissue turns into cysts filled with dark, reddish-brown fluid resembling melted chocolate – hence the name “chocolate cyst.”

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These growths can attach to other organs and cause pain and discomfort. They can also be an indicator of a more severe form of endometriosis, according to official health databases.

Experts estimate that about 10% of people who menstruate have endometriosis, and about 17% to 44% develop ovarian endometriomas. 

A visual depiction of chocolate cysts, the growth Bindi Irwin claims doctors removed to treat her endometriosis.

Ovarian endometriomas are often characterized by the brown, chocolate-like fluid found in cysts along the ovaries. (iStock)

Endometriomas can range in size from very small to very large, and can form on one or both ovaries, Cleveland Clinic states.

The most common signs of the condition are painful period cramps, pain during intercourse or while urinating, more frequent urination, back pain, nausea, vomiting and bloating.

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There is not a known cause of endometriomas, although one theory points to a backwards menstrual flow, called retrograde menstruation, according to Cleveland Clinic.

In this case, instead of exiting the body, uterine tissue travels back through the body into the ovaries, where it thickens and bleeds each menstrual cycle, causing the formation of fluid-filled cysts.

Diagnosis and treatment

Physical exams, as well as imaging procedures like MRIs and ultrasounds, can help diagnose the issue. In some cases, the cysts are so large that doctors can detect them during a pelvic exam.

Doctors can perform a minor surgery called a laparoscopy, in which a sample of the cyst is removed and tested to confirm the diagnosis.

Woman in pain following menstrual cramps

Experts estimate that about 10% of people who menstruate have endometriosis, and about 17% to 44% of those people develop ovarian endometriomas. (iStock)

While there is no cure for ovarian endometriomas, management includes monitoring growths, surgically removing larger ones, and taking medications to regulate hormones that may impact symptoms, according to experts.

Not all cysts need to be removed. In cases of smaller cysts, health professionals may monitor them and reevaluate if symptoms become more painful. 

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“The best treatment for you depends on lots of factors, like your age, your symptoms and your plans for becoming pregnant,” Cleveland Clinic states. “Weigh the pros and cons of your options with your provider to decide the best plan for you.”

Chocolate cysts can come back even after treatment. Per the above source, about one in four people will see an endometrioma return.



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