Comparison Between Combined Oral Contraceptive Pills and Progesterone-Only Pills in The Management of Functional Ovarian Cysts

Background: There are different approaches that have been used for the management of functional ovarian cysts with various outcomes, and the optimal method is still controversial. Objective: This study aimed to compare the effectiveness of oral progesterone versus combined oral contraceptives in women with functional ovarian cysts. Patients and Methods: An observational prospective study was conducted at Tishreen University Hospital in Lattakia-Syria for the period of one year (2022-2023). The study included women with physiological ovarian cysts, who were divided into two groups: group1 included 50 women who received treatment with oral dydrogesterone(10 mg twice a day), and group 2 included 50 women who received treatment with ethinylestradiol –drospirenone. The final outcome and side effects of treatment were compared between the two groups. Results: The ages of the study population ranged from 18 to 40 years, with a mean age of 32.41±7.3. There were no significant differences between the two groups regarding demographic characteristics, clinical manifestations, and ultrasound findings before treatment (p>0.05). Compared with baseline, a significant decrease in the volume of cysts was observed after two months of therapy in group 1 (1.55±0.1 versus 5.14±1.3,p:0.0001) and group 2(1.29±0.1 versus 4.98±1.9,p:0.0001). In addition, there was significant relieving of menstrual disruption, dysmenorrhea, and amenorrhea(p:0.0001) in the two treatment groups. Complete resolution of cysts was observed after one cycle in 92% of the women in group 1 versus 90% in group 2, and side effects were less frequent in women who received oral progesterone without the presence of significant differences between the two groups (p>0.05).Conclusion: Oral dydrogesterone is as effective as combined oral contraceptives for the resolution of physiological ovarian cysts with lower risks of side effects.