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The four primary groups of hormonal medications used for those with endometriosis are: Combined Oral Contraceptives (COCs) Progestins Gonadotropin releasing hormone agonists (GnRH-agonists) Gonadotropin releasing hormone antagonists (GnRH-antagonists) Combined Oral Contraceptives (COCs): Contains both synthetic estrogen and progestin and orally administered Typically lower costs Frequently used for dysmenorrhea (painful periods) Reduces menstrual flow, menstrual and pelvic pain Can be used continuously which may be more effective than cyclic use (placebo pills) Further research is needed to determine their efficacy in managing pain associated with endometriosis.2 Progestins: Progestin only (no synthetic estrogen) Various forms available including oral pills aka the mini-pill, the implant, hormonal IUDs, injections (medroxyprogesterone acetate aka the Depo-Provera shot)