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Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Oral contraceptives for functional ovarian cysts
David A Grimes1, Lashawn B Jones, Laureen M Lopez
1Behavioral and Biomedical Research, Family Health International, PO Box 13950, Research Triangle Park, North Carolina 27709, USA. dgrimes@fhi.org
The Cochrane Database of Systematic Reviews
|April 17, 2009
Summary
Combined oral contraceptives do not hasten the resolution of functional ovarian cysts. Watchful waiting is recommended for two to three cycles, with surgery indicated for persistent cysts.
Area of Science:
- Gynecology
- Reproductive Endocrinology
Background:
- Functional ovarian cysts are common in women of reproductive age.
- Large or persistent cysts may necessitate surgical intervention.
- Oral contraceptives (OCs) have been used clinically to treat ovarian cysts since the 1970s.
Purpose of the Study:
- To review randomized controlled trials (RCTs) evaluating OCs for functional ovarian cyst treatment.
- To determine the efficacy of OCs in resolving functional ovarian cysts.
Main Methods:
- Comprehensive literature search of multiple databases (CENTRAL, MEDLINE, POPLINE, EMBASE, ClinicalTrials.gov, ICTRP).
- Inclusion of RCTs in any language assessing OCs for treatment (not prevention) of functional ovarian cysts.
- Independent data abstraction and analysis using Peto odds ratios and mean differences.
Main Results:
- Seven RCTs involving 500 women were identified.
- Combined OCs did not accelerate the resolution of functional ovarian cysts, whether spontaneous or post-ovulation induction.
- Most cysts resolved spontaneously within a few cycles; persistent cysts were often pathological.
Conclusions:
- Combined OCs offer no demonstrated benefit for treating functional ovarian cysts.
- A strategy of watchful waiting for 2-3 cycles is appropriate.
- Surgical management should be considered for persistent cysts.
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