Medical management of endometriosis

The diagnosis of endometriosis is suspected based on the history and the symptoms and signs, is corroborated by physical examination and imaging techniques, and is finally proved by histological examination of specimens collected during laparoscopy. Medical management most often is the first-line treatment for pain relief and to prevent recurrence after surgery. Treatment strategies for endometriosis are based on its clinical manifestations, that is, pelvic pain and infertility. As both are difficult to assess objectively, one has to direct and interpret treatment response carefully in order to achieve the therapeutic targets with the available options. The endometriotic lesions are hormonally active, and continuous estrogen is required for the growth and persistence of these implants; therefore, they can be suppressed by changing the hormonal milieu. Nonsurgical treatment options for endometriosis can be expectant, analgesics, or can have one or more combination of medical treatments. Expectant management remains an option for women approaching menopause and for those without significant symptoms.