While the treatment for endometriosis has varied over the years, doctors now agree that if the symptoms are mild, no further treatment other than medication for pain may be needed. For those patients with mild or minimal endometriosis who wish to become pregnant, doctors are advising that, depending on the age of the patient and the amount of pain associated with the disease, the best course of action is to have a trial period of unprotected intercourse for 6 months to 1 year. If pregnancy does not occur within that time, then further treatment may be needed. For patients not seeking a pregnancy where treatment specific for the management of endometriosis is required and a definitive diagnosis of endometriosis by laparoscopy has been made, a physician may suggest hormone suppression treatment. Since this therapy shuts off ovulation, women being treated for endometriosis will not get pregnant during such therapy, although some may elect to become pregnant shortly after therapy is stopped.
Hormone treatment is most effective when the implants are small.
The doctor may prescribe a weak synthetic male hormone called Danazol, a synthetic progestin alone, or a combination of estrogen and progestin such as oral contraceptives. We are finding good medical options without surgery. Disease symptoms are improved for 80-90 percent of the patients taking Danazol, and the size and the extent of implants are also reduced. Overall, pregnancy rates following this therapy depend on the severity of the disease. However, some recent studies have shown that with mild to minimal endometriosis, Danazol alone does not improve pregnancy rates.