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Oral contraceptives for functional ovarian cysts
David A Grimes1, Lashawn B Jones, Laureen M Lopez
1Clinical Sciences, FHI 360, PO Box 13950, Research Triangle Park, North Carolina, USA, NC 27709.
The Cochrane Database of Systematic Reviews
|September 9, 2011
Summary
Combined oral contraceptives do not hasten the resolution of functional ovarian cysts. Watchful waiting is recommended for two to three cycles, with surgery considered for persistent cysts.
Area of Science:
- Gynecology
- Reproductive Endocrinology
- Clinical Trials Research
Background:
- Functional ovarian cysts are common in women of reproductive age.
- Large or persistent cysts may necessitate surgical intervention.
- Oral contraceptives (OCs) have been widely used clinically for treating ovarian cysts since the 1970s, based on their association with reduced cyst incidence.
Purpose of the Study:
- To review randomized controlled trials (RCTs) evaluating the efficacy of oral contraceptives in treating functional ovarian cysts.
Main Methods:
- Comprehensive search of multiple databases (CENTRAL, MEDLINE, POPLINE, EMBASE) and clinical trial registries.
- Inclusion of RCTs in any language, focusing on OCs for treatment, not prevention.
- Independent data abstraction and statistical analysis using Mantel-Haenszel odds ratios and mean differences.
Main Results:
- Eight RCTs involving 686 women were analyzed.
- Combined oral contraceptives did not accelerate the resolution of functional ovarian cysts, regardless of spontaneous occurrence or post-ovulation induction.
- Most cysts resolved spontaneously within a few cycles; persistent cysts were often pathological.
Conclusions:
- Combined oral contraceptives offer no demonstrable benefit for treating functional ovarian cysts.
- A strategy of watchful waiting for 2-3 cycles is appropriate.
- Surgical management should be considered for cysts that persist beyond this observation period.
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