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Hormonal treatment options include: Combined oral contraceptives : Continuous or cyclic regimens can reduce menstrual flow and suppress endometrial tissue activity Progestins : Available as oral medications, injections (depot medroxyprogesterone acetate), intrauterine devices (levonorgestrel-releasing IUD), or implants GnRH agonists : These medications induce a temporary menopausal state, effectively suppressing endometriosis but requiring add-back hormone therapy to minimize bone loss and vasomotor symptoms GnRH antagonists : FDA-approved oral options include elagolix (Orilissa) and relugolix/estradiol/norethindrone (Myfembree) with specific duration limits based on dosing and bone health considerations Aromatase inhibitors : Sometimes used in refractory cases, though not FDA-approved for this indication Bone mineral density monitoring is recommended for patients on long-term GnRH agonists or antagonists, particularly at higher doses or extended durations

If you require medication for diabetes control, ask whether switching to or optimizing these agents could help protect the baby while managing your glucose levels

Step 4 Ongoing Monitoring and Program Adjustment: Regular follow-up appointments and monthly body composition scans ensure your plan evolves with your progress continuously optimizing your program for sustained, long-term results