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What are endometriomas?

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Endometriomas are ovarian cysts caused by endometrial tissue growing in the ovary. They are associated with endometriosis and can cause pain, infertility, and heavy periods. Treatment options include surgery and medication.

In medicine, endometriomas are a type of ovarian cyst. Ovarian cysts are sacs of fluid inside a woman’s ovary. Endometriomas occur when a piece of membrane from inside a woman’s uterus collects in an ovary and grows there to form an ovarian cyst. These cysts are also called endometrial cysts, or sometimes chocolate cysts, due to the brown appearance that occurs when these cysts have grown inside the ovary for a long time. The brown color is due to the presence of old and clotted blood suspended in the fluid inside the cyst.

Ovarian endometriomas typically occur in women who suffer from a condition called endometriosis. In endometriosis, cells in the lining of the uterus move and form deposits in areas of tissue where they don’t normally belong. This can include the fallopian tubes, bladder and intestines. Endometrial deposits from endometriosis are, however, more common in the ovaries, and here they often lead to the formation of these cysts.

Symptoms of this condition can include severe ovarian pain, infertility, and heavy menstrual periods, often with large blood clots. Estimates of the frequency of the disease range from five to ten percent, and up to 50 percent of women who have known fertility problems may be present. These cysts occur most commonly in women of reproductive age, although they are known to occur more rarely in postmenopausal women.

Endometrioma treatment can be in the form of surgery or using medications. Surgery is often necessary to remove an endometrioma if fertility is to be preserved. This usually consists of laparoscopic surgery, in which a telescopic device is inserted into the patient’s abdominal region through a small incision below the navel. In such surgery, a doctor normally aims to remove the cyst, or cysts, from the ovary. This can provide quick pain relief and potentially the return of normal fertility. Laser surgery is also sometimes used to cauterize ovarian cysts, but this method tends to remove only the surface of the cyst and may result in incomplete healing.

Medical treatment using drugs is generally considered a satisfactory approach only if the patient is not trying to conceive. The drugs used for treatment are usually hormones that prevent the patient from ovulating. This in turn tends to reduce the proliferation of uterine cells, making endometriomas much less likely to recur.

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