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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 [21] [20] 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 [18] [19] Aromatase inhibitors : Sometimes used in refractory cases, though not FDA-approved for this indication [23] [24] Bone mineral density monitoring is recommended for patients on long-term GnRH agonists or antagonists, particularly at higher doses or extended durations

11 The most common contributory factors to safety in primary care are the quality of communication, diagnostics, and medication management

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They are injected 30 minutes before bedtime, aligning with the body's natural growth hormone release cycle

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