ABSTRACT
The treatment of endometriosis needs to be tailored to the individual woman depending on her symptoms, priorities and the stage of endometriosis. Clinicians should be open and honest about the limitations of current treatment and the likelihood of recurrence. Medical treatment relies on hormonal manipulation of the ovarian cycle and exerts an effect by inducing amenorrhoea. Medical treatment does not improve fertility and is contraceptive. Medical treatment of endometriosis produces no improvement in pregnancy rates compared to expectant treatment. The treatment of choice will depend on the severity of endometriosis, the woman’s age, duration of infertility, past reproductive performance and the presence of other infertility factors such as tubal blockage or male factor infertility. Medical treatment, therefore, should be reserved for those women who need treatment for pain, or as a preparation for surgery. Surgical treatment improves pain, particularly for women with more severe endometriosis.
