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4.2 Hormonal medical treatments Hormonal medical treatments for endometriosis-associated infertility target the endocrine pathogenetic mechanisms of the disease, aiming to block menstruation through inhibition of the hypothalamus-pituitary-ovary (HPO) axis or induction of pseudodecidualization with consequent amenorrhea, thereby impairing the progression of endometriotic implants ( GnRH agonists (goserelin, leuprolide, nafarelin, buserelin, triptorelin) downregulate pituitary GnRH receptors, leading to hypoestrogenism and amenorrhea, which results in regression of endometriotic lesions and improvement in pain symptoms