What is a chocolate cyst?

Chocolate cyst, medically known as ovarian endometrioma, is a common manifestation of endometriosis. It develops when endometrial tissue fragments shed during menstruation flow backward through the fallopian tubes into the pelvic cavity and implant on the surface of the ovary or other pelvic structures, forming ectopic cysts. The old blood accumulated within these cysts is brownish, thick, and paste-like—resembling chocolate—which gives the cyst its name. Various treatment options are available for chocolate cysts. In mild cases, hormonal therapy may be used, such as gonadotropin-releasing hormone (GnRH) analogs to suppress menstruation and alleviate symptoms. For patients with larger cysts or severe symptoms, surgical intervention is commonly recommended, including laparotomy or laparoscopic minimally invasive surgery, aiming to remove the cyst while preserving ovarian function. Traditional Chinese medicine approaches, such as moxibustion and taking herbal medicines that promote blood circulation and resolve blood stasis, can also help relieve symptoms to some extent. The choice of treatment should be individualized based on the patient’s specific condition.