Hormone therapy and anti-inflammatory medicines are the main medical options. The best hormone formulation for the long-term control of heavy menstrual bleeding or menstrual pain is found in oral contraceptives (OCPs). In cases of known endometriosis or fibroids, a GnRH agonist, such as Lupron, can be used for up to six months prior to beginning OCPs. Lupron causes temporary menopause, and shrinks endometriosis and fibroids. Medical options are safer, in most cases, than surgical options, and will be the first line of treatment offered.