Endometriosis in the ovary (endometrioma): Symptoms and Treatment

Ovarian endometriosis, also called endometrioma, is due to the presence of endometrial tissue, endometrial glands or stroma, tissues that should only be inside the uterus, also covering the ovary. The doctor may discover that the woman has endometriosis in the ovary through transvaginal or pelvic ultrasound, which mainly detects an ovary cyst larger than 2 cm, filled with dark liquid.

Normally, when the woman has endometriosis in the ovary, she also has endometriosis in the intestine, this situation being considered for deep endometriosis, since the tissue has spread to several areas. There are practically no cases of isolated endometrioma, as there are always other affected sites.

Endometrioma symptoms

Endometrioma is considered a benign change, however signs and symptoms may appear that may be uncomfortable for women and be indicative of endometriosis in the ovary, such as:

  • Difficulty getting pregnant, even after 6 months to 1 year of trying;
  • Very severe colic during menstruation;
  • Blood in the stool, especially during menstruation;
  • Pain during intimate contact.

The diagnosis is made by the gynecologist based on the vaginal touch exam and image exams, such as transvaginal ultrasound, in which the bowel should be emptied previously, or through magnetic resonance imaging. These tests will highlight the affected sites, which determines treatment.

Treatment for endometriosis in the ovary

Treatment will depend on the woman's age, reproductive desire, symptoms and the extent of the disease. In cases where the tissue is less than 3 cm, the use of medications can be effective, reducing symptoms, but in more severe cases, with a cyst larger than 4 cm, laparoscopic surgery is recommended to scrape the endometrial tissue or even removing the ovaries.

The endometrioma does not disappear on its own, even with the use of the birth control pill, but these can decrease the risk of developing a new endometrioma after its removal through surgery.

In some cases, the gynecologist may also recommend the use of some medications to relieve the symptoms and prevent the progression of the endometrioma, however this indication is made more frequently for women who are already in menopause.

Can endometrioma hinder pregnancy?

As the ovary is compromised, the quantity of eggs produced becomes more reduced, which causes the woman's fertility to be impaired. The chances of pregnancy in women with endometrioma decrease each month according to the evolution of the disease. In addition, the doctor may recommend surgery to remove this tissue, especially when the disease is already more advanced, but the surgery itself can negatively interfere with the ovary, damaging the woman's fertility.

Thus, the doctor can recommend that the woman start trying to get pregnant as soon as possible, or she can indicate the egg freezing technique, so that in the future the woman can decide if she wants to have artificial insemination and have children.

Can endometrioma turn into cancer?

Rarely an endometrioma can turn into cancer, although it can happen, the number of women affected is very small. Furthermore, it is not any endometrioma that can turn into cancer, only the atypical endometrioma, which may be related to the development of endometrial cancer or clear cell cancer. Thus, more than 95% of women with endometrioma will not have cancer.