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This paper evaluated whether high-dose ovulation-suppressing oral contraceptives or gestagen therapy improve resolution of functional ovarian cysts in women of reproductive age, using both a retrospective analysis (113 participants with one-chamber smooth-walled ovarian cysts, >2 cm at cycle start) and a randomized prospective study (59 participants). Participants received either combined oral contraceptives (ethinylestradiol plus desogestrel or ethinylestradiol plus levonorgestrel), continuous lynestrenol, or no medication, and cyst regression was assessed over follow-up. In both studies, there were no differences in cyst resolution between treated and untreated groups, and in the prospective study all cysts resolved within 12 weeks regardless of whether the cysts were spontaneous or related to prior ovulation induction. The only cyst that persisted after 20 weeks was surgically removed and proven to be an endometrioma. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.
Abstract
To investigate the need for hormonal treatment in patients with functional ovarian cysts (FOC), the efficacy of this treatment was evaluated in a retrospective and also in a randomised prospective study. By retrospective analyses the resolution of FOC with a mean diameter larger than 2.0 cm at the beginning of a cycle was determined in 113 patients (31.6 +/- 4.6 years). Fifty-seven women received an oral contraceptive (ethinylestradiol 50 micrograms/d for 7 days, ethinylestradiol 50 micrograms and desogestrel 125 micrograms/d for 15 days), the others had no therapy. In a second study 59 patients (32.3 +/- 4.6 years) were randomised to receive a combination of ethinylestradiol 50 micrograms and levonorgestrel 250 micrograms/d for 21 days (Group 1, n = 24), or lynestrenol 10 mg/d continuously (Group 2, n = 14) or a third group (Group 3, n = 21) without treatment. In both studies no differences were found between those patients who had hormonal treatment and those who had not. The prospective study revealed that spontaneously appearing FOC and FOC evolving after ovulation induction during the cycle prior to study enrolment, resolved equally well within 12 weeks independent of contraceptive or gestagen treatment. FOC persisted in only one woman (group 2) who had a surgically proven endometrioma. In conclusion, hormonal treatment does not produce regression of FOC in women of reproductive age.
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DOI: 10.1055/s-2007-1022807
Zur Rückbildung funktioneller Zysten: Hochdosierte Ovulationshemmer und Gestagentherapie ohne zusätzlichen Effekt
Resolution of Functional Ovarian Cysts: Treatment with Oral Contraceptives or Gestagens has no Additional EffectPublication History
Publication Date:
18 March 2008 (online)
Zusammenfassung
Das Management bei persistierenden Ovarialzysten stellt bei Frauen im reproduktiven Alter ein häufiges Problem dar, wobei vielfach eine ovarielle Suppression mit Ovulationshemmern empfohlen wird. Wir untersuchten in einer retrospektiven Analyse die Rückbildung einkammeriger glattwandiger Ovarialzysten (EGO; Durchmesser über 20 cm zu Zyklusbeginn) bei 113 Patientinnen (31,6 ± 4,6 Jahre), von denen 57 ein Zweiphasenpräparat (7 Tage 0,05 mg Ethinylestradiol, 15 Tage 0,05 mg Ethinylestradiol und 0,125 mg Desogestrel) erhalten hatten. In einer randomisierten prospektiven Studie wurden 59 Patientinnen (32,3 ± 4,6 Jahre) mit EGO erfaßt, von denen 24 ein Kombinationspräparat mit 0,05 mg Ethinylestradiol und 0,25 mg Levonorgestrel (OH) und 14 eine kontinuierliche Therapie mit 2 × 5 mg Lynestrenol täglich (G) erhielten. Einundzwanzig Patientinnen erhielten keine Medikation. Bezüglich der Zystenrückbildung fanden sich in beiden Studien keine Unterschiede zwischen den therapierten und nicht therapierten Frauen. Unabhängig davon, ob die EGO in Zusammenhang mit einer zurückliegenden Stimulationstherapie oder spontan aufgetreten waren, bildeten sich in der prospektiven Studie ohne Therapie und unter OH-Einnahme alle EGO innerhalb von 12 Wochen zurück. Eine unter G verbliebene EGO (Endometriosezyste) wurde nach 20 Wochen operativ entfernt. Bei hoher spontaner Rückbildungsrate ist die Einnahme von Ovulationshemmern oder von Gestagenen zur Behandlung von EGO bei Frauen im reproduktiven Alter nicht indiziert.
Abstract
To investigte the need for hormonal treatment in patients with functional ovarian cysts (FOC), the efficaey of this treatment was evaluated in a retrospective and also in a randomised prospective study. By retrospective analyses the resolution of FOC with a mean diameter larger than 2.0 cm at the beginning of a cycle was determined in 113 patients (31.6 ± 4.6 years). Fifty-seven women received an oral contraceptive (ethinylestradiol 50 μg/d for 7 days, ethinylestradiol 50 μg and desogestrel 125 μg/d for 15 days), the others had no therapy. In a second study 59 patients (32.3 ± 4.6 years) were randomised to receive a combination of ethinylestradiol 50 μg and levonorgestrel 250 μg/d for 21 days (Group 1, n = 24), or lynestrenol 10 mg/d continuously (Group 2, n= 14) or a third group (Group 3, n = 21) without treatment. In both studies no differences were found between those patients who had hormonal treatment and those who had not. The prospective study revealed that spontaneously appearing FOC and FOC evolving after ovulation induction during the cycle prior to study enrolment, resolved equally well within 12 weeks independent of contraeeptive or gestagen treatment. FOC persisted in only one woman (group 2) who had a surgically proven endometrioma. In conclusion, hormonal treatment does not produce regression of FOC in women of reproductive age.
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