A systematic review to determine the effectiveness of medical therapies at causing disease regression in endometriosis

Endometriosis is a common condition affecting around 2–10% of women of reproductive age. Various medical therapies are in widespread use for control of symptoms, however, very little is known of the effect of these therapies on the disease itself. In addition, the natural history of the condition when left untreated is far from clearly understood. If one uses medical therapies for symptom control it is possible the underlying disease may progress insidiously such that, if surgery is required in the future, may be increasingly difficult and hazardous. We reviewed the literature to assess the efficacy of any medically treatment used in endometriosis at causing regression of disease. Despite an extensive search, this issue is addressed adequately by very few studies. The data that are available suggests medroxyprogesterone acetate (MPA) and luteal phase dydrogesterone are probably ineffective at causing disease regression whilst gestrinone appears to be effective. The effects of danazol and triptorelin are inconclusive.