The first daily pill for treating endometriosis symptoms has been approved for use on the National Health Service (NHS) in England. This ‘first-of-a-kind’ treatment offers an alternative for patients who have not found relief from any other medical and surgical treatments. Around 1,000 women with endometriosis could benefit from this new treatment in a year. Endometriosis affects 1.5 million women in the UK, and the new pill is a crucial step for symptom management for those who have struggled with conventional therapies.
What is endometriosis?
Endometriosis is a disease in which tissue similar to the lining of the uterus grows outside the uterus. This condition can cause severe pain in the pelvis and make it harder to get pregnant. Endometriosis can start at a person’s first menstrual period and last until menopause.
Symptoms of endometriosis
Endometriosis is often found in areas around the womb, such as the ovaries, fallopian tubes, and lining of the pelvis. Sometimes it can affect organs, such as the bladder and bowel. In rare cases, endometriosis has been found in areas outside the pelvis, such as in the chest.
This condition causes severe pain in the pelvis, especially during the menstrual period. Some also experience pain while engaged in sexual intercourse or urination. Some people also struggle with getting pregnant due to this condition.
Symptoms during the menstrual period include:
- Severe period pain, that stops you from doing your normal activities.
- Heavy periods.
- Pain when you poo or pee.
Other symptoms include:
- Chronic pelvic pain
- Trouble getting pregnant
- Bloating or nausea
- Fatigue
- Depression or anxiety.
There is no known way to prevent endometriosis, at present according to the WHO. The treatment is based on the severity of the symptoms and also if pregnancy is desired. There are no treatments to cure the disease. The conventional treatments include non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics (painkillers) to treat pain.
Hormonal medicines such as GnRH-analogue and contraceptives to control pain. They include:
- pills
- hormonal intrauterine devices (IUDs)
- vaginal rings
- implants
- injections
- patches
The new pill approved by the drug assessment body the National Institute for Health and Care Excellence (NICE) is called relugolix combination therapy or Ryeqo. This combination drug – relugolix–estradiol–norethisterone is the first long-term daily pill licensed to treat endometriosis.
- Works more quickly than injectable alternatives
- Can be taken at home rather than at clinics
- Combines all needed hormones in one pill
- Returns hormone levels to normal faster when stopped
How does the new pill work?
The newly approved medication, relugolix-estradiol-norethisterone, works by blocking specific hormones that contribute to the progression of endometriosis. At the same time, it provides hormone replacement therapy to prevent severe side effects often associated with hormone suppression treatments. Unlike current injectable treatments, which can initially worsen symptoms and require frequent clinic visits, this daily tablet can be taken at home. “Instead of travelling to clinics for injections, there is now a daily tablet that can be taken at home,” Helen Knight, the director of medicines evaluation at NICE said in a statement.
“The treatment can also be stopped and started more easily, which is particularly important for those planning to have children and for managing side effects,” she added.
How much does the pill cost?
According to NICE, the new combination therapy pill will cost £72 for a 28-day supply. However, this will only be available for people who have tried all other treatments and found no relief.
Helen Knight expressed that this marks “a potential step-change in how we manage endometriosis, putting control back in patients’ hands while ensuring value for the taxpayer”.
(Pic courtesy: iStock)