What is the first treatment tried for ovarian endometrioma?

An ovarian endometrioma is a cyst linked with endometriosis. A clinician usually considers the cyst's appearance, pelvic pain, bleeding symptoms, ovarian function and pregnancy plans before choosing a starting approach. Hormonal treatment can reduce activity of endometriosis and may help control pain, but it does not remove an established cyst. The plan may involve observation and follow-up when symptoms are limited and the scan appearance is reassuring.

Arrange a gynaecology review to discuss the scan findings and your priorities. Ask whether hormonal treatment or monitoring fits your situation, and what change would prompt another scan. If surgery is advised, laparoscopic ovarian cystectomy may remove the cyst while the surgeon aims to preserve healthy ovarian tissue. Read about [GnRH Analogue Therapy](/treatments/medical-gynaecology/gnrh-analogue-therapy/) and [Laparoscopic Ovarian Cystectomy](/treatments/gynaecological-surgery/laparoscopic-ovarian-cystectomy/) to prepare for that conversation.

Seek urgent medical help for sudden severe pelvic pain, faintness, repeated vomiting, fever or heavy bleeding. These symptoms need prompt assessment because a cyst can sometimes be associated with an acute pelvic problem. For background, see [Ovarian Endometrioma](/conditions/ovarian-endometrioma/).

Which features of my scan guide the first treatment? How might treatment affect fertility or ovarian reserve? What symptoms should make me contact the clinic sooner?