How is ovarian endometrioma treated?

An endometrioma is an ovarian cyst containing old blood linked with endometriosis. A clinician considers its size and appearance, pain such as painful periods or pain during sex, changes over time, ovarian reserve and whether pregnancy is desired soon. Monitoring can include repeat scans when symptoms are limited. Hormone treatment can reduce endometriosis activity and pain, but it does not remove the cyst. Surgery may be discussed when pain persists, the cyst has concerning features, or its position interferes with fertility care.

Arrange a gynaecology review to discuss scan findings and your goals. Ask how treatment could affect ovarian tissue and fertility. Laparoscopic ovarian cystectomy removes the cyst through small abdominal openings; recovery and suitability vary. GnRH analogue therapy is one hormone option that temporarily suppresses ovarian hormone signals and may cause menopause-like effects. Keep a record of pain, bleeding and medicines, and do not stop prescribed treatment without advice.

Seek urgent medical help for sudden severe pelvic pain, fainting, repeated vomiting, fever or a rapidly worsening illness. These symptoms can signal torsion, cyst rupture or another urgent pelvic problem. Contact your gynaecology team promptly if pain changes, bleeding becomes difficult to manage, or you may be pregnant.

Ask whether monitoring is reasonable, what the scan shows, how each option may affect ovarian reserve, and whether hormone treatment fits your pregnancy plans. Clarify the expected recovery, warning symptoms and alternatives to surgery.