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They forms dark, fluid-filled cysts, [4] which can vary greatly in size. The fluid inside the cysts is thick, dark, old blood, giving it a chocolate-like appearance, giving it the name chocolate cyst. It can also develop in the cul-de-sac (the space behind the uterus), the surface of the uterus, and between the vagina and rectum. [5]
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[49] [2] A review indicated the usefulness of using calcium channel blockers. [32] Heat is effective compared to NSAIDs and is a preferred option by many patients, as it is easy to access and has no known side effects. [50] Tamoxifen has been used effectively to reduce uterine contractility and pain in dysmenorrhea patients. [51]
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Pain and infertility are common symptoms, although 20–25% of affected women are asymptomatic. [1] Presence of pain symptoms are associated with the type of endometrial lesions as 50% of women with typical lesions, 10% of women with cystic ovarian lesions, and 5% of women with deep endometriosis do not have pain. [19]
As the disease progresses, nonspecific findings can include free pelvic fluid, endometrial thickening, uterine cavity distension by fluid or gas. In some instances the borders of the uterus and ovaries appear indistinct. Enlarged ovaries accompanied by increased numbers of small cysts correlates with PID. [28]
The ligament pulls on nerve fibers and sensitive structures of the female reproductive system. Since the uterus tends to be oriented towards the right side of the body, the pain is also often felt on the right side. This leads to frequent confusion with appendicitis. [6] During pregnancy, the uterus expands to accommodate the growing fetus.
The pain is worse during or after sexual intercourse, and can be worse just before the onset of the menstrual period. [ 8 ] Women with pelvic congestion syndrome have a larger uterus and a thicker endometrium . 56% of women manifest cystic changes to the ovaries, [ 9 ] and many report other symptoms, such as dysmenorrhea , back pain, vaginal ...