Chocolate cyst.

Hello sir , she is suffering from chocolate cyst (6*4cm).
from last 1 month she is taking medicine named “Dynofirst 2 mg”. after taking medicine the pain during periods reduced but after 5 days of period some black thing bleeds out. Then after some days it stopped and even again the period started just after 15 days of the last period.
what to do?

Chocolate cyst.
Answered
Obstetrics & Gynae

Answer ( 1 )

  1. Hello,
    Thanks for the query,
    the chocolate cyst of size 6x 4cm , firstly is not going to get reduced in size and if it is symptomatic in terms of pelvic pain then the best option shall be to remove it laparoscopically. The aim behind advising dinofirst 2mg would have been to control the menses and ideally they should have been started daily and continuously to avoid menses, because chocolate cyst is an endometriosis cyst which would increase in size every time the menses shall occur. So either a progesterone only pill should be taken continuously for 3 months or a laparoscopic intervention should be planned to remove the cyst soon.
    But the regimen of taking dinofirst irregularly or even just for last 15 days of cycle shall allow menses to occur. Also the irregular breakthrough is known side effect of progesterone only pills. You must take the pill not later than a gap of more than 2 hrs each time to avoid such bleeding episodes.
    Regards