Gonadotropinreleasing hormone agonists

1. GnRH agonists inhibit gonadal function, resulting in hypoestrogenism. Pain is relieved in most patients by the second or third month.

2. Intramuscular leuprolide 3.75 mg once monthly or nafarelin, 200 mg nasal spray twice daily for 3-6 months may be used.

3. Side effects, such as osteoporosis, hot flashes, headaches, and depression, are common. Symptoms recur after discontinuation of therapy in most patients.

E. Surgical therapy. Endometriosis is usually treated surgically at the time of diagnosis by laparoscopic cautery. Hysterectomy with bilateral oophorectomy is the definitive treatment for endometriosis.

References: See page 195.

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