Pilule contraceptive.jpg

Ovarian endometriomas, better known as ovarian 'chocolate' cysts for the brown liquid they contain, can be easily removed by surgery. However, recurrence is common, which can cause ongoing pain and complications. A study evaluated for Faculty of 1000 suggests a simple and effective remedy - the oral contraceptive pill (OCP).

In their F1000 evaluation, Neil Johnson and Shelley Reilly from Auckland, New Zealand, highlight a trial published in Fertility and Sterility that provides evidence that the OCP can reduce the reoccurrence of endometriomas after removal by surgery. They say, this study is perhaps the only randomized controlled trial that has evaluated the effectiveness of the use of long-term postoperative OCP treatment to prevent endometrioma recurrence.

The trial consisted of 239 patients who had just undergone surgery to remove endometriomas and who were randomized into groups: those with no prescribed treatment, those taking cyclic OCPs, and those taking continuous OCPs. Patients were followed up for two years.

Women who took OCPs had significantly fewer recurring cysts. Previous studies of the effectiveness of OCPs after laparoscopic cystectomy have produced conflicting results. But long-term treatment seems to be the key: Johnson and Reilly say, the length of treatment appears to play an important role in the efficacy of therapy.

Johnson and Reilly suggest an immediate change to current clinical practice: If the use of an OCP is considered to reduce the risk of recurrence of an endometrioma after laparoscopic cystectomy, treatment should be given for at least two years.