[Verified Answer]: A 30-year-old women who was diagnosed with…

A 30-year-old women who was diagnosed with endometriosis 3 months ago based on a history of dysmenorrhea, intermittent pain with defecation and past history of dyspareunia. She presents to the nurse practitioner today for evaluation and management of continued endometriosis-related pain despite treatment with naproxen. PMH: DVT 4 years ago after a flight treated with warfarin for 6 months. No recurrence. FH: Mother has endometriosis. Father has hypertension and elevated cholesterol levels. Meds Naproxen 250mg three times daily with food at first sign of menses for 5-7 days Multivitamin one daily Assessment: She has chronic pelvic pain and has partial relieve from dysmenorrhea with naproxen. Because of naproxen related side effects and pain at other times besides menses. She would like to consider hormonal therapy. BP:115/70 P:65 RR:15 Wt:72 Pap smear: normal Chlamydia/gonorrhea:negative Questions: 1. What pharmacotherapeutic option would be a choice in this patient to treat pain associated with endometriosis? 2. What are the potential risk and benefit of various treatment options in this patient? 3. Is there any treatment contraindicated in this patient? 4. What clinical and laboratory parameters are necessary to evaluate the therapy? 5. Would your recommendation change if this patient had indicated an interest in having another child in the next 1-2 years.