INCLUSION CRITERIA:
1. Women between the ages of 18 and 45 years, who have their reproductive organs.
2. Excellent health other than a three month history of pelvic pain and documented endometriosis at laparoscopy. Chronic medications may be acceptable at the discretion of the internist associate investigator (LN). Use of antidepressants, medications for migraines and headaches, allergy medications, and treatment of bowel symptoms such as irritable bowel disease will be allowed.
3. Do not desire pregnancy for the duration of the study.
4. Are using abstinence, mechanical (condoms, diaphragms) or sterilization methods of contraception and are willing to continue using them throughout the study.
5. Willing and able to give informed consent.
6. Willing and able to comply with study requirements.
7. Less than grade III overweight or BMI less than 40 kg/m(2).
EXCLUSION CRITERIA:
1. Women with other causes of chronic pelvic pain including infectious, gastrointestinal, musculoskeletal, neurologic or psychiatric.
2. Significant abnormalities in the physical or laboratory examination including renal and liver function more than twice the normal range.
3. Hysterectomy or bilateral salpingo-oophorectomy.
4. Pregnancy.
5. Lactation.
6. Use of hormonal contraception, selective estrogen receptor modulators, progestins, estrogens, steroids, or ovulation induction in the last 3 months.
7. Other medical or surgical treatment for endometriosis in the last 6 months.
8. Untreated abnormal pap smear or other gynecologic condition.
9. History of venous thrombosis events including deep vein thrombosis, pulmonary embolism, and retinal vein thrombosis.
10. Allergy to study drug.
11. History of stroke, complicated migraine, or documented transient ischemic attack.
12. Manic depressive illness or untreated major depression.
INCLUSION/EXCLUSION CRITERIA - REGULARLY CYCLING WOMEN AGED 40 - 50:
Regularly cycling women between the ages of 40 and 50 will have surgically documented endometriosis (preferably biopsy proven, but unequivocal operative reports may allow inclusion) or will be healthy volunteers. Women who are pregnant or lactating or who have abnormalities in the medical history or screening laboratory tests that might contribute to abnormal BMD (e.g. hypercalcemia, renal failure) will not be enrolled. We will not include women who currently or have previously taken medications known to affect bone mineral density (e.g. thyroid hormone suppression, supraphysiologic glucocorticoids, dilantin) or those that suggest menstrual abnormalities (fertility drugs) but we will consider other prescription drug use on a case-by-case basis. Women will be matched by BMI within 5 kg/M(2), ethnicity and by age in two groups: 40-45 years and 45-50 years.
Warren Grant Magnuson Clinical Center (CC)