Endometriosis cysts, also referred to as ovarian endometriomas, are cystic lesions found growing on or inside the ovaries. They are commonly associated with the advanced stages of endometriosis, a condition where endometrial tissue from the inner uterus grows outside of the uterus.

What Is An Endometriosis Cyst?

An endometriosis cyst, or ovarian endometrioma, is a sac on the surface of an ovary or inside the ovary that is filled with endometrial fluid. The fluid inside the cyst is similar to menstrual blood and often turns brown over time. For this reason, endometriosis cysts are also referred to as ‘Chocolate Cysts’. 

Ovarian endometriomas, which are typically associated with stage three or four of endometriosis, are believed to manifest in as many as 17% of women suffering from the condition and can cause the following symptoms:

  • Abdominal bloating
  • Lower back pain
  • Pain or severe discomfort during sex (dyspareunia)
  • Very painful menstruation
  • Pain during urination and bowel movements
  • A frequent urge to pee
  • Nausea
  • Vomiting

An endometriosis cyst is not the same as a functional ovarian cyst, which can happen during the menstrual cycle in otherwise healthy women. 

Endometriosis Cysts vs Functional Ovarian Cysts

Ovarian cysts are divided into two types – functional and pathological. The two types of functional ovarian cysts are follicular cysts & corpus luteum cysts. Follicular cysts occur during ovulation when the follicle fails to burst and release an egg.

Corpus luteum cysts can form when fluid builds up within the residue of a follicle after ovulation. Functional cysts are common & harmless, and typically disappear within a few days. 

Pathological cysts occur when women have endometriosis and it spreads to the ovaries. In this case, endometrial-like tissue grows either inside the ovaries or on the surface of the ovaries. 

How Are Endometrial Cysts Diagnosed?

Although a cyst on the ovaries can be spotted with an ultrasound, it is impossible to know what type of cyst it is without further investigation. 

Once a cyst is detected by ultrasound, healthcare providers would typically carry out another ultrasound within a few weeks. A functional cyst would have decreased in size or disappeared by this time. However, if the cyst remains the same or increases in size, healthcare providers normally recommend a procedure called a laparoscopy to remove it and have it examined in a lab. 

How are Endometriosis Cysts Treated? 

Although certain symptoms of endometriosis can be treated with hormone therapy, it provides little relief from the pain and infertility associated with endometriomas. A laparoscopy, which is also how endometriosis is diagnosed, is the most successful way of removing endometriosis cysts by way of excision. 

During a laparoscopy, a surgeon makes small incisions on the abdomen to insert a tiny camera and surgical tools to remove cysts, lesions, and adhesions that form due to endometriosis. Once the cyst has been removed, painful symptoms often subside. In some cases, removing endometriomas can also improve ovulation and fertility. 

After women have recovered from surgery to remove endometriosis cysts, lesions, and adhesions, deep massage of the pelvic floor with pelvic wands can prevent the formation of painful scar tissue. Pelvic health physical therapy is also beneficial to address pain and re-strengthen pelvic floor muscles.

And vaginal dilators made from firm yet pliable medical-grade silicone can help endometriosis patients to overcome the fear and pain associated with sex and vaginal penetration, allowing them to once again enjoy pain-free and enjoyable intercourse.     


An endometriosis cyst is a sac on the surface of the ovary or within the ovary that is filled with endometrial-like fluid and tissue. In contrast to functional cysts, which often occur and disappear quickly during the menstrual cycle, endometriosis cysts can grow, and cause severe pain, bloating, and infertility for many women. 

If you are regularly experiencing the above-mentioned symptoms, schedule an appointment with your healthcare provider for evaluation and treatment options. 


Mayo Clinic – Endometriosis - https://www.mayoclinic.org/diseases-conditions/endometriosis/diagnosis-treatment/drc-20354661

National Library of Medicine – Endometrioma - https://www.ncbi.nlm.nih.gov/books/NBK559230/

National Library of Medicine – Endometriosis - https://www.ncbi.nlm.nih.gov/books/NBK278996/

Endometriosis News - Endometriosis and Ovarian Cysts - https://endometriosisnews.com/endometriosis-and-ovarian-cysts/

Healthline - What Are Chocolate Cysts - https://www.healthline.com/health/womens-health/chocolate-cyst

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