Although benign functional ovarian ...

Although benign functional ovarian pouchs are often self-limiting, they account for about 200000 hospital admissions for year in the United States and cause considerable morbidity among women of reproductive age. thought results linking the use of high-dose oral contraceptives (OCs) to a reduc incidence of functional ovarian pouchs have not been confirmed, and the validity of modern low-dose OCs is unclear. At least undivided study has linked tubal sterilization to an increased risk of functional ovarian pouchs To investigate the relationships between different forms of contraception and functional ovarian sacs Holt and colleagues performed a case-control reflection of women 18 to 39 years of age who were enlisted in a large health maintenance organization in Washington State.

Medical records and radiology reports were used to identify all women who had functional ovarian pouchs of at least 2.0 cm in diameter diagnosed between January 1990 and June 1994 Pregnant women and those with potentially pathologic pouchs including polycystic ovarian disease, were exclud from the inquiry The 586 women with pouchs who agreed to participate in the consideration were matched by age to 757 command women in the same health maintenance organization. Women with a history of hysterectomy, oophorectomy, or infertility were not eligible to participate. All participants were interviewed about demographic, medical, and lifestyle factors, including contraceptive practices.

Women with functional ovarian pouchs were less likely than direct subjects to be married, to have a corporation education, and to have an income through $45,000, and were more likely than rule women to smoke and have a dead body mass index greater than 257 kg by means of [m.sup.2]. Case subjects and rule subjects had similar reproductive histories, omit that case subjects had a significantly greater history of spontaneous miscarriage. OC were used at any time by 87 percent of case subdues and 86 percent of rule subjects, and were currently being used according to 25 percent of case exposes and 28.6 percent of curb subjects.

After controlling for significant variables, the overall singles ratio (OR) for current OC use was 072 (see accompanying table) compared with no contraception, nonsurgical contraception, or nonhormonal contraception manners In subanalyses, the OR for OC containing 35 mcg of ethinyl estradiol was 069 compared with 079 for OC containing lower doses of estrogen and 076 for multiphasic OC The overall OR for sterilization was 170 and this was higher in women who had undergone postpartum sterilization than in women who had interval sterilization (255 compared with 150) The strongest association was with sterilization before age 30 (OR, 354; confidence interval [CI], 124 to 1011) however the time from sterilization was not associated with risk of functional ovarian cysts

The authors bring to an end that current OC use is associated with a pure decline in the risk of exhibition of functional ovarian cysts, still that the use of recent low-dose OCs has little or no clinical tenor on the likelihood of developing functional ovarian sacs Conversely, sterilization, especially at a young age, appears to significantly increase the risk of functional ovarian pouchs This finding confirms those of an earlier contemplation in which the risk of ovarian pouchs was doubled (from 12.4 percent to 241 percent) in women who had been sterilized. Because surgical sterilization is the most numerous common form of contraception in the United States, the authors call for further studies to confirm this increased risk.

Holt VL et al. Oral contraceptives, tubal sterilization, and functional ovarian pouch risk. Obstet Gynecol August 2003; 102:252-8

COPYRIGHT 2004 American Academy of Family Physicians

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