Medical management often takes 3-4 months to become effective and many of these medications can only be given safely for up to 6 months. Therefore, the woman suffering from the endometriosis will often request more aggressive care.
Surgery is clearly an alternative with a typically rewarding outcome.
All the medical management options for treating endometriosis include medications that temporarily prevent pregnancy by disrupting ovulation. To be perfectly safe, one should consider contracepting after initiating these medications until a state of anovulation is achieved. Clinical reports comparing the various medications in terms of effectiveness in pain management suggest that they are generally comparable to one another. Many of these medications have significant side effects that the patient may find disagreeable. The dramatic decrease in circulating estrogen is thought to be the primary mechanism of action for GnRH agonists in the treatment of endometriosis.