Which of the following should be considered a first-line therapy option for managing endometriosis?

• A. Danazol
• B. Gonadotropin-releasing hormone analogs
• C. Progesterone therapy
• D. Spironolactone

Answer: (C)

Progesterone therapy is considered a first-line option for managing endometriosis due to its ability to suppress the growth of endometrial tissue. This is accomplished by promoting a decidual reaction within the endometrial lesions, leading to reduced pain associated with the condition. Progesterones can help to alleviate symptoms such as dysmenorrhea and pelvic pain, making them effective in the treatment of endometriosis.

Progesterone acts by countering the proliferative effects of estrogen, which is known to stimulate the growth of endometrial tissue. This hormonal manipulation not only reduces the overall menstrual cycle symptoms but also can help in shrinking endometrial implants over time.

Other therapies, while useful in specific circumstances, may not be considered first-line. For example, Danazol can be effective in treating endometriosis but often has a profile of side effects that can limit its use as a first-line option. Gonadotropin-releasing hormone analogs can also be effective in managing symptoms but are typically reserved for patients who do not respond to other treatments due to potential side effects and the need for add-back therapy to mitigate these issues. Spironolactone is primarily a diuretic used in conditions such as hypertension and is not a