Comparison of Hormone Therapy with Expectant Management in the Clinical Management of Functional Ovarian Cysts: A Randomized Clinical Trial

Introduction: The current study aimed at comparing the effect of oral contraceptive pills (OCPs) with expectant management in treatment of functional ovarian cysts. The study was conduct to compare the effect of hormone therapy with expectant management in the treatment of functional ovarian cysts. Hormone therapy for functional cysts is widely used in clinical practices, but the efficacy of this treatment is not determined. Methods: The current randomized, clinical trial was performed on 50 females with functional ovarian cysts (40 to 95 mm in diameter) in reproductive age, within the age range of 18 to 48 years, referred to the Clinic of Gynecological Diseases in a private hospital as outpatient from May 2015 to September 2016. The cysts were identified by transvaginal ultrasonography. All the patients had stable vital sign, mild to moderate abdominal discomfort. The patients were randomly divided into two equal groups and followed for eight consecutive weeks. Group A (n= 25) was observed without hormone therapy, only with some analgesics if needed, and the Group B (n=25) received OCPs. After follow-up period, cysts improvement status was compared between the groups. Results: Although nonsignificant, the chance of recovery reduced in patients with each passing year [(odds ratio (OR) =0.985; 95% confidence interval (CI): 0.902-1.077]. In addition to the insignificant results, the odds of improvement in the severe and moderate pain groups were 0.777 and 2.023 times higher than that of the mild pain group. The feeling of heaviness increased the odds of improvement by 1.161. As well, the patients who had cysts for more than three months were 1.264 times more prone to recovery than the ones with younger cysts. Nausea and the absence of internal echo inside the cysts decreased the odds of improvement. However, the impact of none of the abovementioned factors was significant on the treatment of cysts. Conclusions: Based on the results of the current study, the expectant management is as effective as OCPs for the treatment of functional ovarian cysts; in other words, the rate of disappearance of functional ovarian cyst was not affected by OCP use. However, further studies with larger sample sizes are needed to increase the study power and obtain more conclusive results.