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According to major international guidelines, low-dose combined hormonal contraceptives (CHCs) and progestogens are standard first-line treatments for symptomatic endometriosis, effective in approximately two-thirds of symptomatic women ( Combined oral contraceptives (COCs) are commonly used off-label to suppress ovarian function and reduce symptoms, though evidence supporting their effectiveness is less robust, with about 50% of patients reporting partial or no symptom improvement