The size of the cyst does not seem to have an effect on the symptoms. The symptoms, when they do manifest, can be seen as:

• Irregular periods
• Stomach cramps
• Inability to conceive
• Painful sexual intercourse

A chocolate cyst may be formed because of endometriosis.

• A rupture of a chocolate cyst will cause severe pain. It needs emergency treatment.
• Chocolate cysts may affect a woman’s ability to get pregnant.
• Lower number of eggs may be produced by the ovary.
• The eggs that are formed may not be well developed.
• Elevated levels of follicle stimulating hormone which point to problems with the ovary.

However, it is to be noted that with treatment, it is possible for women with chocolate cyst to get pregnant.

• Physical pelvic examination
• Ultrasound abdomen
• Once an ultrasound confirms a cyst, a biopsy of the cyst will be needed to diagnose a chocolate cyst.

Treatment will depend on the patient’s condition – age, presence of cyst in one or two ovaries, desire to have children, etc.

• If the cyst does not cause any problem, it is best to just observe it.
• Birth control pills can be prescribed to stop cyst growth and help with pain management.
• Surgery is recommended when the cyst size exceeds 4 cm and is causing a lot of problems. If cancer is suspected, it is best to remove the cysts.
• Laparoscopic surgery which is minimally invasive can be done to remove the cysts.

• Regular and sufficient exercise
• Avoiding alcohol
• Reducing caffeine consumption (as it increases estrogen level)