What is a recognized effect of continuous combined oral contraceptive (cOCP) use in women with endometriosis?

The use of continuous combined oral contraceptives (cOCPs) in women with endometriosis has several recognized effects, one of which is the potential influence on endometriomas, particularly larger lesions. Continuous cOCPs function by suppressing ovarian function and consequently reducing menstruation, which can help manage the symptoms associated with endometriosis.

Specifically, one recognized concern when using cOCPs is the risk of rupture of large endometriomas. Endometriomas, which are cysts formed from endometrial tissue growing in the ovaries, can become quite large. Changes in hormonal levels due to cOCP use might contribute to alterations in the cyst wall, potentially leading to rupture. This can cause significant pain and other complications, making it an important consideration for management in patients with endometriosis.

The other options discuss incorrect associations. For instance, the suggestion that cOCPs increase symptoms in a large percentage of patients is contrary to the general evidence supporting their use for symptom relief. cOCPs are widely recognized for their effectiveness in reducing endometriosis-related pain and symptoms. Additionally, they do offer a complementary approach to NSAIDs, rather than being less effective, as they address the underlying hormonal mechanisms