Objectives: Hemorrhagic ovarian cyst (HOC) usually resolved spontaneously by 8-12 weeks. But persistent ovarian cyst needs surgical management. Present study aimed at finding out medical management of this entity.

Method: Diagnosed HOC cases were observed for 12 weeks at first for spontaneous resolution. After 12 weeks persistent HOC were subjected to medical management with Bromelain (180mg) + Trypsin (96mg) + Rutosidetrihydrate (200mg) – 1 tab BDAC for 2 weeks, followed by Bromelain (90mg) + Trypsin (48mg) + Rutosidetrihydrate (100mg) – 1 tab BDAC for 2 weeks starting form 1^st week of menstrual cycle. Along with this from 1^st day of the cycle she was given low dose OCP (Ethimylestradiol 30 µgm + Desogestel 150 µgm) 1 tab daily and continued un interruptedly for 3 months. Transvaginal ultrasound was repeated after 3 months of therapy.

Result: Total 35 patients were recruited for the study, but 4 lost to follow-up. Clinical features revealed that most of them (58%) were presented with pain lower abdomen during menstruation with or without lower backache. HOC was diagnosed during luteal phase in 80.6% cases. Disappearance of persisted HOC after 3 months medical therapy was 61.3% which is statistically significant (p< .05).

Conclusion: Bromelain, trypsin, rutosidetrihydratealongwith low dose OCP is a promising treatment modality for persisted hemorrhagic ovarian cyst. Further study will confirm this.

Key words: Bromelain, hemorrhage, rutoside, trypsin

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