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Why does lower abdominal pain occur after intercourse in cases of ovarian endometrioma (chocolate cyst), and what should be done?

May 26, 2023 Source: Cainiu Health
Dr. Lv Aiming
Introduction
Chocolate cysts, also known as endometriomas, may cause lower abdominal pain after intercourse due to cyst rupture, vaginal laceration, pelvic infection, or other causes. Chocolate cysts are typically caused by retrograde menstruation, ovarian epithelial cell differentiation, genetic factors, and similar conditions. In affected individuals, endometrial cells become displaced to the ovaries; as these cells gradually proliferate, they form a cystic mass.

Endometrioma, also known as chocolate cyst, may cause lower abdominal pain after sexual intercourse due to reasons such as rupture of the chocolate cyst, vaginal laceration, or pelvic infection. Treatment should typically be carried out under a doctor's guidance based on specific conditions. Detailed analysis is as follows:

1. Rupture of Chocolate Cyst

Chocolate cysts are usually caused by retrograde menstruation, ovarian epithelial cell differentiation, genetic factors, and other factors. In this condition, endometrial cells migrate to the ovaries. As these cells gradually proliferate, they form a cystic mass. If the chocolate cyst ruptures accidentally during intercourse, it may lead to lower abdominal pain. In such cases, immediate medical attention at a正规 healthcare facility is required, and treatment via laparoscopic surgery should be performed to remove the diseased tissue.

2. Vaginal Laceration

If intercourse involves excessive force, it may cause tearing of the fibrous layer within the vagina, resulting in vaginal laceration and damage to the vaginal mucosa. This may produce the aforementioned symptoms. Under medical guidance, medications such as metronidazole suppositories or tetracycline tablets may be used for treatment. Sexual intercourse should be avoided during the treatment period.

3. Pelvic Infection

Pelvic infection may result from pathogens such as *Chlamydia trachomatis*, anaerobic bacteria, or aerobic bacteria. Under stimulation by inflammatory factors, lesions may develop in the pelvic region and potentially affect the ovaries, causing the described symptoms. In such cases, medications like injectable doxycycline or azithromycin dry mix suspension should be used according to medical advice.

In addition to the above, conditions such as endometriosis, peritonitis, or ovarian cyst torsion may also lead to this phenomenon. It is recommended that patients with chocolate cysts pay attention to the frequency of sexual intercourse in daily life.


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