Oral contraceptive type and functional ovarian cysts

Abstract

Objective: We tested the hypothesis that multiphasic, low-dose monophasic, and high-dose monophasic oral contraceptives share a common protective effect against functional ovarian cysts.

Study design: We conducted a cohort study using the automatic files of Maine Medicaid to assemble a population of 7462 women between the ages of 15 and 44 who were prescribed an oral contraceptive between Jan. 1, 1987, and Dec. 31, 1988. We included as cases 32 women with a principal diagnosis of a functional ovarian cyst confirmed by medical records as being greater than 20 mm in diameter.

Results: At comparison with the absence of an oral contraceptive prescription, we observed decreasing rates of functional ovarian cysts among women prescribed multiphasic pills (rate ratio 0.91, 95% confidence interval 0.3000 to 2.31), low-dose monophasic pills with less than or equal to 35 micrograms estrogen (rate ratio 0.52, 95% confidence interval 0.17 to 1.33), and high-dose monophasic pills with greater than 35 micrograms estrogen (rate ratio 0.24, 95% confidence interval 0.01 to 1.34).

Conclusions: The protective effect of oral contraceptives against functional ovarian cysts reported previously for high-dose monophasic pills may be attenuated with newer pills of lower hormonal potency.

PIP: It was hypothesized that multiphasic, low-dose monophasic, and high-dose monophasic oral contraceptives (OCs) share a common protective effect against functional ovarian cysts. A cohort study using the automatic files of Maine Medicaid examined a population of 7462 women between ages 15-44 who were given an OC between January 1, 1987-December 31, 1988. Included as cases were 32 women with a principal diagnosis of functional ovarian cyst confirmed by medical records as being 20 mm in diameter. Among women prescribed multiphasic pills, there was a decreasing rate of functional ovarian cyst (rate ratio .91, 95% confidence interval .3000-2.31), low-dose monophasic pills with or=35 mcg estrogen (rate ratio .52, 95% confidence interval .17-1.33), and high-dose monophasic pills with 35 mcg estrogen (rate ratio .24, 95% confidence interval .01-1.34). The protective effects of OCs against functional ovarian cysts reported previously for high-dose monophasic pills may be attenuated with the newer pills with lower hormonal potency.