title: [Medical treatments of presumed benign ovarian tumors].
abstract: Medical treatment of functional cysts and endometriomas, and the risk of developing functional ovarian cysts in different therapeutic situations are assessed. The available literature regarding the treatment of functional cysts is limited both by the number of studies and the variability of criteria used to define cysts. There is no evidence to support any efficiency of a medical treatment (LE1). However, oral contraceptive use reduces the risk of development of functional cysts (LE2). Using a second generation combination is recommended as a first-line option in order to reduce thromboembolic risk (LE1). Tamoxifen is significantly associated with an increased risk of developing unilocular cysts before menopause (LE2). For endometriomas, GnRH-agonists are not recommended before cystectomy in order to facilitate surgery (grade C) or to prevent recurrence (grade B). After surgery of endometriomas, the use of an intrauterine device with levonorgestrel or oral contraceptives significantly reduces the volume of the cyst in case of recurrence (LE3); oral contraceptives reduce the recurrence rate of endometriomas (LE2); the use of a low-dose oral contraceptive decreases the frequency and severity of long-term dysmenorrhea (LE1).
authors.affiliation: Service de gynécologie-obstétrique et médecine de la reproduction, hôpitaux universitaires Paris-Est, site Tenon (AP-HP), université Pierre-et-Marie-Curie, 4, rue de la Chine, 75020 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Thomin
authors.forename: E
authors.initials: E
authors.lastname: Daraï
authors.forename: N
authors.initials: N
authors.lastname: Chabbert-Buffet
mesh_terms: D000284:Administration, Oral; D003276:Contraceptives, Oral / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004338:Drug Combinations; D004715:Endometriosis / Q000000981:diagnostic imaging / Q000188:drug therapy; D004997:Ethinyl Estradiol / Q000008:administration & dosage; D005260:Female; D006801:Humans; D009652:Norpregnenes / Q000008:administration & dosage; D010048:Ovarian Cysts / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D014463:Ultrasonography
chemical_list: D003276:Contraceptives, Oral; D004338:Drug Combinations; D009652:Norpregnenes; C494367:estroprogestin; D004997:Ethinyl Estradiol
keywords: Contraception; Endometrioma; Endométriome; Kyste de l’ovaire; Medical treatment; Oral contraceptives; Ovarian cyst; Traitement médical; Œstroprogestatifs