Endometrioma is the formation of endometrial tissue inside the ovaries caused by endometriosis. Endometrioma is a type of ovarian cyst known to produce symptoms like intense pelvic pain, bleeding, and inflammation. It’s also a type of cyst known to produce complications like twisted ovarian cyst and ruptured cysts.
In order to understand how endometriomas form, we first have to look at what endometriosis is and how it develops. Endometriosis is a common chronic reproductive system disorder that affects around 10 to 15 percent of women worldwide. It is also the leading cause of pelvic pain among women.
Endometriosis happens when the endometrium, the lining of the uterus that eventually becomes the material that’s discharged during menstruation, spreads outside the uterus and lines other organs like the fallopian tubes or the pelvic canal.
The endometrium binds to the blood vessels of these structures. And when a woman menstruates, the endometrium breaks down to form part of the menstrual blood. The breaking down of the endometrium outside of the uterus is what causes the symptoms and discomfort associated with endometriosis.
Sometimes, not all of the endometrium goes out of the body as menstruation. Some parts stay behind and form cysts called endometriomas. The problem with endometriomas is that it can be a little tricky to diagnose. These symptoms are fairly similar to patients with acute pelvic inflammatory disease or appendicitis. That’s why an accurate diagnosis is important. In fact, the only way to diagnose them is through a series of diagnostic tests like ultrasound and laparoscopy in order to confirm their diagnosis.
Endometriomas are also called chocolate cysts because of how these tumors are formed. The endometrium is rich in blood, so as the cysts developed they become filled with chocolate colored, coagulated blood. When one of these cysts rupture, the woman would experience bleeding and see coagulated blood along with the discharge. The woman may also experience intense pelvic pain, increase in white blood cell count and low grade fever.
Ovarian torsion or twisted ovaries are commonly caused by endometriomas. The reason for this is because the ovaries are especially susceptible to endometriomas due to its position. The ovaries are adjacent with the tubes to the opening of the pelvic area which makes the ovaries more prone to contamination when the menstrual flow is discharged. The ovary’s high level of steroid hormones compared to other organs makes it an ideal environment for development of endometrial tissue.
Endometrioma can only be treated through surgery. The procedure usually involves puncturing the cyst to drain the fluid. Once the blood has been drained, the cyst can be removed surgically or with the use of a laser. Then all the affected blood vessels have to be cauterized to prevent internal bleeding.
Removal of endometriomas has to be done with care because any damage to the ovary can cause serious complications. Best case scenario, the injury on the ovaries may cause some temporary hormonal imbalances and cause mild symptoms like headaches and menstrual irregularities. Worst case scenario, the ovaries can be permanently damaged so the woman becomes infertile. For the best outcomes, endometriomas should be treated right away, as soon as they’re diagnosed, in order to get rid of the symptoms and preserve the woman’s fertility.
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