What causes chocolate cysts?

Many people want to know the cause of chocolate cyst attacks, because this disease brings great harm to patients. It is a lesion of endometriosis. This cyst can gradually increase in size and sometimes rupture during or after menstruation, but rarely becomes malignant. The following is an introduction to the cause of chocolate cyst attacks.

1. Implantation Theory

This theory was proposed by Sampson in the 1920s. The main point of this theory is that the endometrial fragments shed during menstruation flow backward through the fallopian tube into the abdominal cavity with the menstrual blood and implant in the ovary. This endometrium grows and spreads like seeds and develops into chocolate cysts. It is now found that 80% of women have menstrual backflow, but only a few actually develop the disease, which shows that the endometrium implanted in the ovary needs certain conditions to grow.

This theory holds that ectopic endometrium originates from endometrial tissue, which migrates to sites outside the uterine cavity and then implants and grows. Common routes of transmission include retrograde menstruation, iatrogenic implantation, lymphatic spread, and vascular dissemination.

2. Coelomic metaplasia theory

The ovarian capsule, pelvic peritoneum, etc. originate from the body cavity epithelium. After repeated stimulation by menstrual blood, hormones or chronic inflammation, they can metamorphose into the endometrium and form endometriosis.

So far, there is no ideal radical cure except radical surgery. Both drug treatment and conservative surgery have a high recurrence rate. Therefore, the treatment should be selected according to the patient's age, symptoms, signs, lesion range, and fertility requirements, emphasizing individualized treatment.