Comparative study of the effects of treatment with herbal product shilanum and high-dose contraceptive pills on functional ovarian cysts

Background: Functional ovary cysts (FOC) are among the most common problems in women of reproductive age. Present treatment consists of either high-dose birth control pills or surgery while preserving ovarian tissue. Recent studies have questioned the effectiveness of birth control pills, with some studies even showing them to be ineffectual. The incidences of side effects, therapeutic failure, and unnecessary surgeries for ovarian functional cysts have led us to perform this study comparing the effects of an herbal product of jujube and high-dose birth control pills on FOC regression. Materials and Methods: Sixty women of childbearing age with functional ovarian cysts with diameters of 2-6 cm were randomly divided into two groups that received either high-dose contraceptive pills or Shilanum capsules, a herbal product with an extract of jujube as its active ingredient. Cyst regression was evaluated by transvaginal ultrasound examinations on the second or third day of the second menstrual cycle or after one month and repeated the following month in the case of persisting cysts. Data were analyzed using Chi-square and t-tests as well as other analytical tests where necessary. Results: Sixty patients with a diagnosis of functional ovarian cyst were enrolled. However, at the end of the study, given that some patients failed to refer for further ultrasound evaluation and were inaccessible, data from 26 subjects in the high-dose birth control pill (HD) group and 27 in the Shilanum group were analyzed. Baseline characteristics such as education, professional status, and medication intake were similar. The average age of all participants was 32.61±7.35 years, all of whom were married. Average cyst size before treatment was 27±7mm in the HD group and 39±14mm in the Shilanum group. After treatment, cysts regressed in all patients except for two patients in each group. Conclusion: The Shilanum herbal product with an extract of jujube as its active ingredient was effective on the regression of functional ovarian cysts in more than 90% of cases without any side effects. Since its effect was similar to HD pills, it can be suggested as an alternative to oral contraceptive pills(OCPs) in treating functional ovarian cysts. However, due to the fact that this is the first study with this combination, further studies with larger sample sizes are recommended.