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Chocolate Cysts, Their Fertility Impact and How to Rebalance the Body

Chocolate Cysts, Their Fertility Impact and How to Rebalance the Body

If you’ve been diagnosed with chocolate cysts on one or both ovaries, you may be feeling concerned or alarmed. A chocolate cyst is technically an endometrioma, which is a type of ovarian cyst that is filled with old blood (hence the name chocolate). A chocolate cyst forms when endometrial tissue abnormally grows in the ovaries, as it can with endometriosis.

While they sound scary, chocolate cysts are actually common. They occur in around 20-40% of women with endometriosis, and they don’t always affect fertility. Further, there are natural ways to help your body normalize if you have endometriosis with chocolate cysts.

Chocolate Cysts’ Impact on Fertility

Endometriosis affects an astounding 5-10% of all women, and not all of them have fertility problems. A woman with chocolate cysts may not experience any issues or pain. She may only discover she has them through a vaginal ultrasound or X-ray.

A chocolate cyst begins as a small lesion on the ovaries. It may remain very small (just a few millimeters in size) and is not a cause for concern. However, some cysts grow large (over 10 cm) or become very painful with the menstrual cycle. Larger cysts tend to be the most problematic for fertility, causing blockages or decreased egg quality.

Chocolate Cysts: Medical Treatment Benefits and Drawbacks

Chocolate cysts can be removed through laparoscopic surgery. However, today some doctors suggest leaving small, painless cysts alone. While removal is intended to be minimally invasive, there is a risk of creating scar tissue, worsening the cyst or damaging healthy ovarian tissue.

Cysts that are large or painful should be medically monitored. If a chocolate cyst ruptures, its contents can enter the pelvic cavity. This can cause the ovaries to bind to the fallopian tubes, creating fertility blockages and pain. In severe cases, chocolate cysts can affect ovarian reserve, damage the ovaries, or even require oophorectomy (removal of one or both ovaries).

Chocolate Cyst Symptoms To Watch For: Work with a OB/GYN for a definitive diagnosis.

  • Painful menstruation
  • Pain during intercourse (Dyspareunia)
  • Pelvic pain/abdominal swelling
  • Fertility problems
  • Diminished ovarian reserve, low AMH levels

Natural Therapies To Rebalance The Body With Chocolate Cysts

Endometriosis is triggered by the immune and reproductive systems being out of balance. Natural therapies are a good choice for cysts that are small and do not threaten the health of the ovary.

1. Follow a Nutrient-Dense Fertility Diet. Eliminate triggers like gluten, hormone-injected meat and dairy products that increase pain and worsen hormone imbalance. Choose organic foods whenever possible to avoid exposure to chemicals that affect immune health.

2. Consider a Fertility Cleanse. A Fertility Cleanse helps cleanse excess hormones and toxins in the system that ignite endometriosis. A cleanse takes about 30 days and can help give your body a fresh start. Some women experience increased energy or easier cycles after cleansing.

3. Try an antimicrobial herbal formula. Goldenseal (Hydrastis canadensis), Jamaican Dogwood (Piscidia erythrina), Red Raspberry (Rubus idaeus), Wild Yam (Dioscorea villosa) and more can help reduce inflammation and support normal reproductive function. A formula like Women’s Best Friend can be used for up to 4 months in a natural fertility program.

4. Balance excess estrogen with DIM. DIM (diindolylmethane) can help your body eliminate excess estrogen that fuels endometriosis growths. General dosage: 100-400mg daily with meals.

5. Add antioxidants. Women with endometriosis need more antioxidants to fight inflammation and damage to ovarian reserve. Learn more: New Research Shows The Importance of Antioxidants for Women with Endometriosis.

6. Systemic Enzymes promote normal immune system balance. In endometriosis, the immune system is challenged by increased free radical activity, inflammation, and abnormal tissue growths. Systemic Enzymes support normal body processes, and can even help break down excess tissue and scarring.


If you have endometriosis and chocolate cysts and are facing long-term fertility challenges, it may be best to work with a naturopath or fertility herbalist to find the right therapies for you. Surgical approaches also provide benefits, but working with a surgeon experienced with endometriosis is important. Whatever your therapy choices, make a commitment to be patient and consistent. The rewards of a healthier, more fertile body await you!


Dr. Christine Traxler M.D., OB/GYN
Dr. Christine Traxler M.D., OB/GYN

Dr. Traxler is a University-trained obstetrician/gynecologist, working with patients in Minnesota for over 20 years. She is a professional medical writer; having authored multiple books on pregnancy and childbirth; textbooks and coursework for medical students and other healthcare providers; and has written over 1000 articles on medical, health, and wellness topics.  Dr. Traxler attended the University of Minnesota College of Biological Sciences and University of Minnesota Medical School,  earning a degree in biochemistry with summa cum laude honors in 1981,  and receiving her Medical Doctorate degree (MD) in 1986.

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  1. Avatar

    I have a small 1.5cm chocolate cyst and I been taking DIM for 2 years. I think DIM does a lot on stop growing my cyst. I want to increase the egg quality and try to get pregnant soon. I have period cramp (not from the chocolate cyst) every month. My AHM level is normal. Any supplement you recommend for period cramp and also increase fertility in my case? Thanks!

  2. Avatar

    A formula like Women’s Best Friend can be used for up to 4 months in a natural fertility program?
    where is the “Women’s Best Friend” ? I cannot find it , thanks

  3. Avatar

    how to get pregnant if less ovarian reserve

    • Dear Fatima,

      Thank you for reaching out to us here!

      As we age there are a variety of factors that effect hormone levels, ovarian reserve and egg health ~ from environmental toxins, poor food choices/lack of nutrition, poor circulation, free-radicals from stress, exposure to toxins on foods and in our environments, stress, hormonal imbalance, illness and injury, genetic factors, autoimmune disorders, etc. It is important to work to protect and support long-term health, including egg health. To learn the best ways to improve egg health naturally, take time to read over our complete Increase Egg Health Guide because increasing egg health may help to sustain the follicles that are still viable.

      If you are still unsure of where to begin, or how to proceed after reading the Increase Egg Health Guide, please consider working one on one with our fertility herbalist who can lay out an entire natural fertility program for you based on your specific fertility health needs. This if offered through a Fertility Consultation.