Considerations in selecting appropriate medical therapy for endometriosis

The mechanisms of action of estrogen/progestin oral contraceptives, derivatives of testosterone including danazol and synthetic luteinizing hormone or gonadotropin-releasing hormone agonists in the treatment of endometriosis are reviewed. The selection of therapy depends on the stage of endometriosis, symptoms, current and future fertility needs, patient's age and recurrence rates. The efficacy, dosing regimens, effects on menstruation and fertility, recurrence rates and potential adverse effects, with particular emphasis on bone loss, of alternative therapies are compared.