Danazol was the first drug approved in America for treatment of endometriosis by pseudomenopause, and it came as no surprise to find out that it does not eradicate endometriosis since it was never scientifically proved that the menopause eradicates endometriosis.

It is now realized that danazol does not eradicate endometriosis of any stage or location, and the hopes dashed by danazol seem to be a combined result of historically misplaced expectations, errors of visual identification, and failure to confirm clinical observations by biopsy. Reports on the use of danazol for endometriosis have shown an actual decrease in fertility in treated women with minimal or mild disease compared to operative laparoscopy or observation only while the improved pregnancy rate following surgical therapy for disease associated with pelvic adhesions has long been recognized.

Since there is a surprisingly high background pregnancy rate of up to 57% in untreated disease in infertile patients, the true effect of medical or surgical therapy on fertility is difficult to determine, since it may be small. It seems most likely that much of the "improved" fertility after treatment is due to the natural history of endometriosis, not to the treatment itself.

Urologists have questioned the use of danazol for endometriosis involving the urinary tract, noting it to be ineffective for relief of obstructive ureteral endometriosis. Since danazol does not eradicate endometriosis, it is also not surprising that it is ineffective in long term relief of pain.

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