I. Definition Endometriomas - Chocolate Cysts are definition as a
health condition of endometrial cells forming in the outside of the
ovaries, leading to endometriosis on the surface of the ovaries. They
also react to hormone stimulation during the menstrual cycle, by
building up tissue, breaks it and eliminates it through menstrual period
that causes blood spilling over the abdominal cavity, causing menstrual
cramps and pain. Since chocolate cysts - endometriomas are filled with a
thick chocolate-type material, they are called chocolate cysts.
II. Causes of chocolate cysts - endometriomas The causes of
endometriomas are still unknown, here are some suggestions and theories.
1. Retrograde menstruation The retrograde menstruation theory suggests
that during menstruation the blood flows backward instead of outward
causing menstrual blood to go through the fallopian tubes to the pelvic
and abdominal cavity, resulting in blood embedding on the outside of the
ovaries, causing endometriomas.
2. Weakening of immune system Normally, the immune will destroy
endometrial cells which are located outside the uterus. If the immune
system is weakened and no longer functions normally, it will allow the
endometrial cells that shed to attach and grow on the surface of the
ovaries.
3. Stress and emotion During stress and emotion, the adrenal glands
produce cortisol which affects the function of the body to cleanse
toxins resulting in stimulating the growth of endometriomas.
4. Embryonic theory This theory suggests during the embryonic stage,
some endometrial cells which normally grow in the uterus instead
develops in the ovaries.
5. Hormone imbalance Endometriomas happen during reproductive years
of women when estrogen and progesterone are most active. In each stage
of the menstrual cycle, estrogen and progesterone must be balanced for
women to conceive. Any imbalance of hormones during the menstrual cycle
causes conversion of estrogen into bad estrogen and over-production of
prostaglandins, leading the cervix to contract resulting in no escaping
of the menstrual period, causing menstrual cramps and endometriomas.
Nutritional deficiency is also one of the causes of hormone imbalance.
6. Hereditary Endometriomas may be genetics passing through from
generation to generation or it may be resulted from genetic errors,
causing some women to become more likely than others to develop the
condition. Study shows that women are 5 times more likely to develop
endometriomas if her sister has it. It is wise for these women to have
children in their early reproductive years.
7. Toxic environment Study shows that exposing our body to toxins
found in pesticides and some harmful waste products may have some
hormonal and chemical influence, causing activation of endometriomas at
the time of menstrual cycle. resulting in proliferating of endo-tissues
to the ovaries/
8. Xenoestrogen Interaction of our body with certain chemicals causes
a disruption of the body's hormones as resulting of over-production of
estrogen converting to xenoestrogen to stimulate the growth of
endometriomas.
9. Sex during menstruation. Sexual intercourse during menstruation
causes the endometriosis tissue to travel into the fallopian tubes then
into the ovary resulting in developing ovarian endometriomas.
III. Symptoms of chocolate cysts - endometriomas 1. Progressively
increasing dysmenorrhea (menstruation cramps and pain) They are caused
by contractions of uterine muscles as resulting of over production of
certain hormones of the prostaglandins family from the endometriomas, as her periods become more painful or that the pain begins earlier or lasts longer.
2. Pain during intercourse The penetration motion of the penis can
produce pain in an ovary bound by endometrial implants or adhesion.
3. Severe period pain It normally happens with over-production of
prostaglandins and leukotrient causing the cervix to contract resulting
in no escape for the menstrual period.
4. Difficult to get pregnant If the cyst is presented in the ovary,
it will respond to hormone changes in the menstrual cycle causing the
cysts to get large every month blocking the normal function of ovaries
resulting in infertility.
5. Pain elevate to ward the end of period. Since the blood cannot
escape, it retents in our body causing damage to the organs or any part
of the body hosting the endometriosis resulting in severe pain toward
the end of the period.
9. Pain in one side of pelvic Pain on one side of the pelvic during
menstrual cycle may be caused by endometrial implants or adhesion to
that side of the ovary.
IV. Diagnosis 1. Physical Exam Normally, during annual pelvic exam,
if the mass of endometiomas are large enough, they can be detected.
2. Ultrasonography It is defined as a diagnostic imaging technique
that uses high frequency sound waves to create a picture of our body
internal organs including tendons, muscles, joints, vessels. Accuracy in
diagnosing endometriomas varies with the experience of the radiologist.
There are two types of ultrasonography diagnosis a) Ultra sound In
order to evaluate the abdominal including the uterus. You will be lying
down with a full bladder for the procedure then a high frequency waves
will pass through your body abdominal region with a medical device move
back and forth in the abdomen with a thin jellylike substance applying
to the skin on your abdomen to improve the contact of your body. After
the image is taken, either the operator or the doctor in the office will
explain to you what have been seen. You will be asked to either take
the image to your doctor or they will send it. If there are
endometriomas or chocolate cysts, they will be captured in the image
because of their darker shapes than other fluid filled cysts.
b) Trans vaginal ultrasound Trans vaginal ultrasound is defined as
ultrasound taken with a transducer inserted into the vagina ( if you are
discomfort with this procedure, you may ask the operator that you will
do the insertion yourself to decease your discomfort). The transvagina
ultrasound works well for measuring the thickness of the endomerium,
endometrial hyperplasia, endometriomas and cancer.
3 . Laparoscopy Your physician suspect the disease if you complains
of severe menstrual cramps or pain with intercourse, he/she may suggest
laparoscopy to look in side your uterus and ovaries, so he/she can
visually confirm the presence of the endometriomas and gauge its extent
and most of the time, a small piece of tissue can be removed for biopsy.
V. Treatments A. Medication 1. Creating a continual pregnancy
state These types of medication help to stop or reduce period with
stimulating the corpus luteun in ovary to continue producing
progesterone such as continuous dose of the Pill, Provera and Danazol.
2. Reducing the blood flow volume Beside the Pill as we mentioned
above, progestogens are one of the conventional medication that use in
maintaining pregnancy. With high progesterone in your body, it reduces blood flow in menstruation or tricks your body to think that you are pregnant.
3. Create a menopausal state It is necessary for the surge of
estrogen for woman's body to start the menstrual cycle, estrogen
inhibitors medication stop the production of estrogen from the ovary
resulting in tricking your brain that you are now at menopausal state.
Without surging of estrogen there is no menstrual cycle. These types of
medication include all GnRH agonist range of drugs.
4. Stop the pain Over producing of prostaglandins that control the
ovarian muscles contraction will cause menstrual pain. These types of
medication include prostaglandins inhibitor medicines, the Pill,
painkiller, etc.
5. Regulating hormone swing These types of medication are used to
treat symptomsof endometriosis or pre menstruation in menstrual cycle
such as depression, anxiety. It includes the Pill, anti depressants, etc.
B. Side effects and risks In general, taking the above medication may
cause the following side effects and risks. 1. Blood clots 2. Stroke
and heart attacks 3. Weight gain 4. Hormonal imbalance 5. Long term loss
of period after coming off the Pill in some women. 6. Nausea 7.
Bloating 8. Breast tenderness 9. Male pattern hair growth and deepening
of voice 10 Indigestion 11. Etc.
B. Surgery 1. If fertility is a concern then a) Laparoscopy Most
laparoscopies are completed in a hospital and usually performed under
general anesthesia. A laparoscopy is a medical instrument that is used
by a doctor for viewing and tissues removing in the operation table.
Through a incision at the abdominal wall, the thin instrument passes
into the abdominal cavity. Laparoscopic hysterectomy is an operation
that involve in removing the present of endometriomas during the course
of the laparoscopy. Today, many physicians insert a slightly larger
telescope through the umbilical port, which allows them to use a carbon
dioxide laser to destroy the endometriomas.
b) Laparotomy Similar to laparoscopy, laparostomy is a surgery
performed through a larger incision. You may be required to stay 1 to 3
days in the hospital following the surgery. If exceedingly large ovarian
cysts, ovarian cysts are found and suspicious for cancer.
c) Risks 1. Bleeding caused by medical instrument during operation.
2. Injure to adjacent organs caused also by medical instrument during
surgery. 3. Infection 4. Anesthesia risk.
2. If you are over 40 and fertility is not a concern Then your
gynecologists will recommend the removal of both ovaries by bilateral
oophorectomy General anesthesia is needed and the operation is done in
the hospital.
a) Normally, bilateral oophorectomy is done with a laparoscopic
surgery. Laparoscope is a thin tube containing a tiny lens and light
that inserts through a small incision in the navel with a camera on the
other end that allows your doctor to see the abdominal cavity on a video
monitor. Both ovaries are removed though a small incision at the top of
the vagina.
b) Vertical incisions Vertical incisions give the doctor better view
of of the abdominal cavity but it will leave some notable scar. If
cancer is detected, a vertical abdominal incision is needed. After the
incision the ovaries are removed.
c) Horizontal incision If the ovaries are removed by horizontal incisions, it will leave a less notable scar.
d). Risk and side effects i) Heavy blood loss caused by medical
instrument used during surgery. ii) Heaving bleeding during or after
operation iii) Infection of the incision area, may be caused by bacteria
or medical instruments. iv) Needed to stay to hospital for 2 - 5 days
v) Time to recover is longer. It may take 3- 6 weeks to return to normal
activity.
VI. Endometriomas and Fertility Some women with endomatriomas can
conceive naturally, but unfortunately for some, if the endometriomas
grow large enough to block the extruding of egg into the fallopian tube.
It is evidence that endometriomas also affect the quality of egg and
impair ovulation in some women. 1. Treatment with medication In case of
endometriosis interfere with production of the egg, fertility medication
may be required for production of many eggs, resulting in increasing
the chance of conception such as Clomid.
2. Treatment with artificial insemination a) In vitro fertilisation
(IVF) In IVF , sperm is introduced to the egg outside of women body,
after fertilization, it will be implanted back to the woman's uterus.
b) Intrauterine insemination (IUI) IUI is a relatively simple
infertility treatment. It places some selected sperms directly into the
uterus.
c) Gamet Intrafallopian transfer (GIFT) If the endometriosis
interferes with the with function of the ovary, GIFT is helpful to
assist reproductive treatment by placing the egg and sperm cells into
one of the fallopian tubes.
d) Intracytoplasmic sperm injection (ICSI) For the same reason above,
ICSI technologies inject one sperm cell directly into an egg, with a
small, specialized needle.
I will come back with another article "Endometriomas - Chocolate
Cysts - In Traditional Chinese Medicine Perspective", please bear with
me. At the mean time enjoy reading
Pregnancy Miracle
Reverse Infertility And Get Pregnant Naturally
Using Holistic Ancient Chinese Medicine
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
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