Adenomyosis and ovarian chocolate cysts (collectively referred to as coeliac disease) are two of the most prevalent gynecological diseases in recent years. Not only that, but these two difficult diseases sometimes appear in one woman at the same time, adding to the suffering of those who are already experiencing them. Adenomyosis Adenomyosis is a diffuse or limited invasion of the endometrial glands and mesenchyme into the myometrium of the uterus. With the menstrual cycle, it also sheds and bleeds, forming small sacs that grow. So the lesion also grows and the uterus enlarges. Adenomyosis specifically manifests as dysmenorrhea, heavy menstrual flow, infertility, enlarged uterus… The symptoms manifest themselves more and more severely with the duration of the disease. Ovarian chocolate cysts Coeliac disease is an invasion of the endometrium into the ovaries, where it makes its home and grows. This ectopic endometrium, which is also affected by sex hormones, will also menstruate and repeatedly shed and bleed with the cycle, but the menstrual blood on these ovaries, obviously, does not flow out, and cannot flow out of the body, so – over time The old blood is definitely not bright red but coffee-colored and thick like paste, like chocolate, so that’s how chocolate cysts come about. How to treat adenomyosis combined with coeliac cysts? For patients with fertility needs, if the uterus is not large but the coeliacs are larger than 4 cm and there is a need for fertility, the coeliacs can be considered first and can be removed laparoscopically. For patients with less than 4 cm, we can consider trying to conceive directly. This is because smaller ovarian chocolate cysts are usually less likely to rupture. However, when the cyst increases to more than 3 or 4 cm, the risk of spontaneous rupture begins to appear and gradually increases. It grows to a certain size and spontaneous rupture is often difficult to avoid and can be painful for the patient, and after conservative treatment, the cyst wall rupture heals and the symptoms disappear, but spontaneous rupture may occur again soon. The more episodes she has, the heavier the pelvic adhesions will be, and the abdominal pain caused by pelvic adhesions will add to her misery. Therefore, those who are diagnosed with ovarian chocolate cysts, with a diameter of 4 cm or more, should be operated in time. Pregnancy can be a very positive factor in preventing recurrence of the cyst and in relieving adenomyosis. Patients with significant symptoms For patients with severe menstrual pain that affects their normal work life (no need to have children), regardless of the size of the uterus and the size of the coeliacs, it is recommended to undergo adenomyosis-conserving surgery as soon as possible to solve the adenomyosis lesions and remove the coeliacs together, even if cysts, myomas and ectopic lesions are found. All problems are solved at once, and after the operation, no more menstrual pain, normal menstrual flow, normal size of the uterus, and fertility are preserved. In this way, patients can avoid repeated surgeries. Otherwise, if you have ovarian surgery this month and then come back next month for uterine surgery, repeated surgery will increase the financial burden of the patient and increase the physical pain of the patient. If the symptoms are not obvious, if the dysmenorrhea is tolerable, the menstrual flow is normal, there is no discomfort, the uterus is not large, and the coeliac is less than 4 cm, you can consider temporary observation and conservative treatment without surgery. The above are some suggestions for patients with adenomyosis combined with coeliac disease. In general, adenomyosis and coeliac disease are both gynecological diseases that are more dangerous for women’s health, and both of them may appear at the same time in clinical practice, and these two diseases not only seriously affect patients’ physical and mental health, but also seriously interfere with patients’ normal life. Therefore, we would like to remind all the patients of adenomyosis and coeliac disease that they need to undergo corresponding treatment in time after discovering the disease, so as not to delay the aggravation of the disease and symptoms.