Hi, The combined pill like Losterin is often prescribed as the first line of treatment, with the aim of reducing pain. If this controls symptoms like pain, then the assumption is that underlying disease is not progressing. Withdrawal bleeds while on the combined pill are usually much lighter than regular periods. They don t improve significant endometrial shedding, which in theory reduces the risk of endometriosis. However, endometriosis is an estrogen dependent disease. So, taking estrogen and having regular hormone exposure with monthly bleeds could result in ongoing pain symptoms and disease progression. Progesterone only pills are another option, if this is the case. Progesterone only pills contain progestin and no estrogen. The suppress endometrial growth and often stop menstruation. But it also don t suit everyone. Some women may get side effects like mood swings, breast tenderness and enlargement, increased hair growth, reduced libido, acnes etc., from the progesterone only pills. Intrauterine devices like Mirena is a good option for them as it releases progestin directly into the uterus and stop uterine endometrial growth and reduce menstruation as well as pain. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Zubayer Alam, General And Family Physician