The first daily pill for treating the symptoms of endometriosis has been approved for use on the NHS – but only in select cases.

The new tablet, known as Ryeqo or relugolix-estradiol-norethisterone, has been approved to treat women of reproductive age for whom other treatment options – including medical and surgical routes such as hormonal contraceptives and IUDs – haven’t been successful.

Also known as relugolix combination therapy, the pill works by putting the body into a type of ‘medical menopause’ while simultaneously delivering hormone replacement therapy (HRT). In this way, it’s supposed to block the hormones that contribute to the condition while providing replacement hormones that allow the body to continue to function properly.  

While this kind of treatment – known as a GnRH antagonist – already exists, it’s currently given as an injection or with an implant and needs to be accompanied by a separate HRT tablet. This new all-in-one pill will allow for patients to administer their treatment at home.

The daily nature of the pill also means that hormone levels return to normal faster than they would with an injection or implant once stopped. This makes it much easier to come off the pill due to uncomfortable side effects or a desire to get pregnant, whereas the injection or implant can take anywhere from four to 12 weeks.

And while current treatments of this type are typically only licensed for up to six months of use, experts say this treatment can be continued all the way up until menopause.

It’s been recommended that patients taking the pill have a DXA (bone density) scan after one year of treatment to check the hormone replacement hasn’t had an adverse effect, as low oestrogen levels can put you at higher risk of osteoporosis or bone loss. Those at higher risk of these outcomes will also require a scan pre-treatment. 

“This new treatment marks a potential step-change in how we manage endometriosis,” said Helen Knight, director of medicines evaluation for the National Institute for Health and Care Excellence, who approved the new treatment. “[It puts] control back in patients’ hands while ensuring value for the taxpayer.”

However, Endometriosis UK has warned that the scope of this new treatment may be limited. While the charity welcomed the approval of the new medication, it said it may only be suitable for a small number of the 1.5 million patients with the disease.

“In addition to the creation of new treatments, Endometriosis UK is keen to see more investment in research to find the cause of the disease, better management and treatment options, and one day a cure,” the group said in a statement. 

The new treatment option comes after a recent study found that women with endometriosis take a direct hit to their earnings following diagnosis.

The research, undertaken by the Office for National Statistics, found women aged 25–54 years in England who received an endometriosis diagnosis between April 2016 and December 2022 saw their pay decrease by £130 a month in the four to five years post-diagnosis.

The study also revealed that women are more likely to leave full-time employment following a diagnosis. 

Images: Getty