What is the first-line treatment for moderate to severe symptoms of endometriosis?

The first-line treatment for moderate to severe symptoms of endometriosis is hormonal therapy. This approach focuses on the hormonal regulation of the menstrual cycle, as endometriosis is influenced by estrogen. Hormonal treatments can help reduce menstrual flow and alleviate pain by suppressing the growth of endometrial tissue.

Common forms of hormonal therapy include oral contraceptives, progestins, and GnRH agonists, which work to lower estrogen levels and inhibit the proliferation of endometrial tissue. These treatments can significantly reduce pain and improve the quality of life for those suffering from moderate to severe symptoms.

Other options, such as surgical intervention, may be considered for patients who do not respond to hormonal therapy or have severe disease causing significant anatomical distortion or complications. However, surgery is not the first-line treatment as it carries risks and does not address the underlying hormonal influences on endometriosis. Antibiotic therapy is not relevant in the treatment of endometriosis unless there is a concurrent infection, and physical therapy might assist in managing pain but does not treat the underlying condition. Hence, hormonal therapy is the most appropriate initial choice for managing moderate to severe endometriosis symptoms.