From the Guidelines
A progesterone cyst, also known as a corpus luteum cyst, is a normal ovarian structure that typically resolves on its own within 1-3 menstrual cycles without requiring treatment, as indicated by the O-RADS US risk stratification and management system 1.
Key Characteristics of Progesterone Cysts
- These cysts develop when the corpus luteum fills with fluid instead of dissolving after ovulation.
- Most progesterone cysts are small (under 3 cm), cause no symptoms, and are often discovered incidentally during pelvic exams or ultrasounds.
- According to the O-RADS guidelines, a corpus luteum less than 3 cm is considered almost certainly benign and requires no further management 1.
Management of Progesterone Cysts
- If the cyst causes pain, over-the-counter pain relievers like ibuprofen (400-600 mg every 6 hours) or acetaminophen (650 mg every 6 hours) can help manage discomfort.
- For women experiencing recurrent or painful cysts, hormonal birth control pills may be prescribed to prevent ovulation, as supported by evidence on the use of synthetic progestogens 1.
- Medical attention should be sought if severe pain, fever, vomiting, dizziness, or rapid breathing occurs, as these could indicate complications like cyst rupture or torsion.
Importance of Watchful Waiting
- Progesterone cysts are physiological and represent normal ovarian function rather than a disease process.
- The standard approach for management is watchful waiting, given the high likelihood of spontaneous resolution within a few menstrual cycles, as implied by the O-RADS guidelines for almost certainly benign lesions 1.
From the Research
Progesterone Cyst Overview
- Progesterone cysts, also known as functional ovarian cysts, are a common gynecological problem among women of reproductive age worldwide 2.
- These cysts may require operations, sometimes resulting in removal of the ovary, but most cysts resolve without treatment within a few cycles 2.
Diagnosis and Management
- The American College of Obstetricians and Gynecologists (ACOG) stated that simple cysts found on ultrasound may be safely followed without intervention, even in postmenopausal women 3.
- Diagnostic consideration and surgical management of ovarian cysts are discussed, including the use of transvaginal ultrasonography (TVU) and CA-125 blood tests 3.
- Ovarian cysts were present in 1.6% of women at screening, 2.0 to 2.4% of LNG-IUS 13.5mg users during Year 1, and 1.9 to 2.1% during Years 2 and 3 4.
Hormonal Contraceptives and Ovarian Cysts
- The use of hormonal contraceptives, such as oral contraceptives and intrauterine systems, has been studied in relation to ovarian cysts 2, 4, 5, 6.
- Treatment with combined oral contraceptives did not hasten resolution of functional ovarian cysts in any trial 2.
- The prevalence of ovarian cysts in users of Implanon and Jadelle subdermal contraceptive implants was higher than in users of intrauterine contraceptive (IUC) 5.
- The protective effect of oral contraceptives against functional ovarian cysts may be attenuated with newer pills of lower hormonal potency 6.