The article discusses the use of synthetic analogues — agonists of endogenous gonadotropic releasing hormone (aGnRH) as the «gold standard» for the medical treatment of endometriosis. With the proven mechanisms of the pathogenetic regressive effect of aGnRH on endometrioid implants, one compares not only gestagens and combined hormonal contraceptives already widely used in different countries at the first stage of hormonal therapy for patients with endometriosis, but also drugs that are currently being tested, such as aromatase inhibitors and modulators progesterone receptors. The modern pathogenetic prevention of endometriosis is the use of hormonal contraceptives from the beginning of sexual activity during unplanned pregnancy and further at intergenerative intervals. An algorithm of the main approaches to the treatment of patients with endometriosis using modern hormonal drugs and paying attention to their age, to their nearest and distant reproductive plans is presented. In the absence of conservative hormonal therapy effect — surgical treatment is required.