Endometriosis--what can medical therapy offer?

Endometriosis is often debilitating and can adversely affect fertility. Medical management has largely consisted of hormonal therapy, employing the entire spectrum of sex steroids, singly or in combination, and has primarily aimed to relieve pain and increase conception rates. Recently the efficacy of such treatment has been called into question. The current status of the hormonal therapy of endometriosis is critically reviewed, with sufficient historical background and summaries of clinical trials to allow interpretation of the available data. The impact of hormonal therapy on the cause and the natural history of disease is also assessed. Finally, recommendations regarding therapy, along with necessary directions for future clinical studies, are presented.