Primary prevention

Combined oral contraceptive use decreases lifetime ovulation occurrence and prevents the cyclic gonadotrophin elevations that trigger follicle development. Not only is ovarian cyst development decreased, but any use yields a 40% relative risk reduction for ovarian cancer.[21][22] Long-term use (15 years or longer) provides a 90% risk reduction for ovarian cancer.[21][22] The use of oral contraceptive pills is not recommended as a primary preventative strategy in all women, but cyst prevention is a benefit for women who choose to use them.

Prophylactic oophorectomy, although not recommended for prevention of benign ovarian cysts, can be offered to women with known BRCA-1 or BRCA-2 mutations or Lynch II syndrome, or to post-menopausal women undergoing hysterectomy for benign reasons.[9][23][24][25]

Secondary prevention

Adnexal masses thought to be functional ovarian cysts can be followed expectantly for 2 or 3 menstrual cycles. Treatment with combined oral contraceptives does not appear to hasten resolution. Persistent cysts and those that are large or painful usually merit surgical management.[66]

Use of this content is subject to our disclaimer