Hindawi Publishing Corporation BioMed Research International Volume 2014, Article ID 191967, 12 pages http://dx.doi.org/10.1155/2014/191967 Review Article Medical Treatments for Endometriosis-Associated Pelvic Pain Gabriella Zito,1 Stefania Luppi,2 Elena Giolo,2 Monica Martinelli,2 Irene Venturin,1 Giovanni Di Lorenzo,1 and Giuseppe Ricci1,2 1 Department of Medical Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy 2 Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, Italy Correspondence should be addressed to Giuseppe Ricci;
[email protected] Received 17 November 2013; Accepted 26 May 2014; Published 7 August 2014 Academic Editor: Mohamed Mabrouk Copyright © 2014 Gabriella Zito et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endometriosis associated pain is still represented by oral contraceptives used continuously. Progestins represent an acceptable alternative. In women with rectovaginal lesions or colorectal endometriosis, norethisterone acetate at low dosage should be preferred. GnRH analogues may be used as second-line treatment, but significant side effects should be taken into account.