For patients with endometriosis who have a contraindication to, or cannot tolerate, estrogen-containing (combined hormonal) contraceptives, standard estrogen-based management is not appropriate. This protocol addresses that specific clinical scenario.
This applies to patients with endometriosis for whom estrogen — specifically combined hormonal contraceptives — is either contraindicated or not tolerated. In this population, progestin-only methods may be considered as first-line options where estrogen cannot be used.
Progestin-only methods (i.e., oral, depot, implant, or hormonal intrauterine systems) are other first-line options that may be considered for those who cannot tolerate or have contraindications to estrogen.
Surgical management is indicated if empiric therapy is ineffective, if medical management is not tolerated, or to immediately diagnose and treat the patient, as in the case of an adnexal mass or treatment of infertility.
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