Endometriosis, commonly known as “chocolate cyst,” is one of the most frequent conditions affecting women of reproductive age. It is a significant health issue that can negatively impact both quality of life and fertility.

Endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus, often causing severe menstrual pain. According to Dr. Hasan Can Toyganözü, an Obstetrics and Gynecology Specialist at Medline Adana Hospital, early diagnosis allows for easier pain management and helps prevent fertility-related problems.

Commonly Known as ‘Chocolate Cyst’

Endometriosis, also referred to as “chocolate cyst” among the public, is a chronic condition that can seriously affect women’s quality of life and often progresses silently. It is seen in approximately one out of every seven women, particularly those in their reproductive years. The disease occurs when the tissue lining the uterus, known as the endometrium, is found outside the uterus — for example, on the ovaries or around the fallopian tubes. These tissues respond to the hormonal changes of the menstrual cycle by thickening, breaking down, and bleeding each month. However, since this tissue is located outside the uterus, the blood cannot be expelled from the body. Over time, this trapped blood may cause inflammation, adhesions, and cyst formation in the affected areas.

Menstrual Pain Should Be Taken Seriously

Endometriosis is a condition that can be brought under control when detected early. However, the widespread belief that menstrual pain is “normal” often delays diagnosis. In reality, if the pain is severe enough to affect daily life, it should be considered a warning sign of an underlying condition. For early detection, it is crucial for women to understand their bodies, pay attention to persistent pain, and not neglect regular gynecological check-ups.

Pain May Continue Beyond Menstruation

Severe pelvic pain during menstruation, lower back pain, pain during intercourse, prolonged bleeding, abdominal bloating, and digestive problems are among the key symptoms of endometriosis. In some women, the pain persists even outside the menstrual period, which can be both physically and emotionally exhausting. Although the exact cause is unknown, genetic predisposition, immune system disorders, retrograde menstrual flow, and environmental factors are believed to contribute to the development of the disease.

Minimally Invasive Surgery Plays a Key Role

In the diagnostic process, the patient’s medical history, gynecological examination, and ultrasound are the first steps. Since small lesions may not always be visible on ultrasound, laparoscopy—an endoscopic procedure that allows direct visualization inside the abdomen—can provide a definitive diagnosis. This method serves both diagnostic and therapeutic purposes, as cysts or adhesions can be removed during the same procedure. Treatment is personalized according to the patient’s condition. Painkillers and hormonal therapies are often used to manage pain, while minimally invasive (laparoscopic) surgery is preferred for larger cysts.

Physical and Psychological Effects

Endometriosis can affect fertility. A decrease in ovarian reserve, blockage of the fallopian tubes, or intra-abdominal adhesions may reduce the chance of pregnancy. Therefore, early evaluation is essential for women who plan to have children. With early diagnosis and appropriate treatment, pregnancy can be achieved naturally or through assisted reproductive techniques. The disease also has a psychological aspect, as chronic pain and fertility concerns can cause emotional distress. Professional counseling, regular exercise, healthy nutrition, and stress management can significantly improve treatment outcomes.