Endometriosis, adenomyosis, and fibromatosis are benign uterine conditions affecting women at various ages with different symptoms. Medical treatment plays an important role in the management, especially in diffuse forms and in those women requiring preservation or restoration of fertility. Medical treatments are effective in improving symptoms: pain, abnormal uterine bleeding, and infertility, resulting very frequently in a more acceptable option than surgical treatment. The rationale for using medical treatment is based on the pathogenetic mechanisms of the diseases: sex steroid hormones aberrations, impaired apoptosis, and increased inflammation. Hormonal treatments (progestins, oral contraceptives, gonadotropin-releasing hormone analogues) are currently used off-label to control pain symptoms and abnormal uterine bleeding. An antiproliferative and anti-inflammatory effect of progestins, such as dienogest, danazol, and norethindrone acetate, suggests their use in medical management mainly to control pain symptoms. On the other hand, the intrauterine device releasing levonorgestrel resulted is extremely effective in resolving abnormal uterine bleeding and reducing uterine volume in a long-term management plan. In conclusion, based on new findings on pathogenetic mechanisms, new drugs are under development for the treatment of endometriosis, adenomyosis, and fibromatosis such as selective progesterone receptor modulators, aromatase inhibitors, valproic acid, and anti-platelets therapy.