Endometrioma (also called chocolate cyst) is the presence of tissue similar to, but distinct from, the endometrium in and sometimes on the ovary.

[3] When the endometrial mucous membrane is found outside of the uterus in places such as the ovaries, it causes chronic pelvic pain with intercourse and menstrual cycles.

Another factor that endometrioma can impact is the ovarian reserve, or the number of quality follicles left in the ovary to produce viable eggs.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used first in patients with pelvic pain, particularly if the diagnosis of endometriosis has not been definitively (excision and biopsy) established.

GnRH can be combined with estrogen and progestogen (add-back therapy) without loss of efficacy but with fewer hypoestrogenic symptoms.

Therapy with these agents has a large number of sometimes permanent side effects, such as hot flushes, loss of bone mass, deepening of voice, weight gain, and facial hair growth.

However, despite the fact that there is a risk of loss of ovarian function, studies have shown the recurrence rate of endometrioma is reduced.