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Oral contraceptives for functional ovarian cysts
David A Grimes1, LaShawn B Jones, Laureen M Lopez
1Obstetrics and Gynecology, University of North Carolina, School of Medicine, CB#7570, Chapel Hill, North Carolina, USA, 27599-7570.
The Cochrane Database of Systematic Reviews
|May 1, 2014
Summary
Combined oral contraceptives do not hasten the resolution of functional ovarian cysts. Watchful waiting is recommended, 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 were historically used to treat ovarian cysts based on their preventative association.
Purpose of the Study:
- To review randomized controlled trials on oral contraceptives for treating functional ovarian cysts.
Main Methods:
- Systematic search of multiple databases (CENTRAL, PubMed, EMBASE, POPLINE, ClinicalTrials.gov, ICTRP) and reference lists.
- Inclusion of randomized controlled trials in any language, focusing on treatment, not prevention.
- Independent data abstraction and statistical analysis (odds ratio, mean difference) by two authors.
Main Results:
- Eight randomized controlled trials involving 686 women were analyzed.
- Combined oral contraceptives did not accelerate the resolution of functional ovarian cysts.
- Most cysts resolved spontaneously; persistent cysts were often pathological.
Conclusions:
- Combined oral contraceptives offer no proven 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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