There was a lot of excitement in the headlines in March that there was a new endometriosis pill that had been approved for use for endometriosis on the NHS. I myself was really intrigued as I work with so many endometriosis clients that have suffered for such a long-term and are always holding out hope that new medication and research may finally be able to address endometriosis at a more root cause level. But when I looked closer I realised a very disappointing truth… the headlines were drawing us in to see what we have seen time and time again, another bandaid solution for women’s health.
Ultimately when we look closely this pill will have a very limited availability and is designed to manage symptoms rather than address anything at a deeper level, therefore providing a very small number of women with another bandaid solution.
So let’s look closer at a few important points about this “new” endometriosis medication.
This new pill is marketed as an every-day long-term use pill for endometriosis, it has been branded as Myfembree but is also known as relugolix (or Ryeqo).
- This new endometriosis pill isn’t actually new.
The first point to note is that this is not a new medication at all, it simply has a new brand name (attempting to make it appealing and feminine with the name Myfembree) and it has new approved usage for endometriosis in the UK. This medication has been used for prostate cancer and uterine fibroids and even for endometriosis cases in the US, Australia and Europe for those with a history of previous medical or surgical treatment.
- It is only available to a limited number of women (and only after all other medication and surgery has not been successful).
This is because this relugolix combination pill is only allowed to be prescribed after all other previous medications and surgeries have failed or not been successful in managing the symptoms of endometriosis. This means only an estimated 1,000 women in the UK will even be able to access it this year.
- The contents of this pill leave much to be desired.
This pill contains relugolix, estradiol and norethisterone. So let’s break down what that means…
Relugolix – This is an oral gonadotropin-releasing hormone-receptor antagonist. That means that it blocks GnRH receptors in the pituitary gland (in the brain) from regulating LH and FSH which in turn regulate oestrogen and progesterone. This means simply that it prevents your body from making its own hormones.
The goal of this is ultimately to reduce estrogen in order to prevent proliferation of endometriosis but in turn also stops ovulation.
Estradiol – This is a bioidentical form of estrogen that is added back into the pill in order to negate any potential negative side effects from the relugolix. This is added at a much lower dose than if you were to make your own estrogen.
Northisterone – This is a progestin. This is a synthetic progesterone (that acts a little bit more like testosterone in the body due to its strong affinity to binding to androgen receptors – hello weight gain, acne and head hair loss…).
So to put it simply this endometriosis pill acts like a contraceptive pill as it shuts down your body’s production of your own hormones and ovulation… and yes you can use it as one too (after a month of use).
So to summarise this pill is another disappointing bandaid solution to endometriosis sufferers that aims at reducing symptoms by reducing oestrogen levels.
A reminder on what drives endometriosis
Endometriosis is an estrogen-dependent inflammatory and immune disease, resulting in growth of endometrial-like tissue outside of the uterus. Important to note is that although oestrogen is important in the development of endometriosis, first and foremost it is an inflammatory and immune disease that acts more like an auto-immune disease, this is where the research needs to be focused.
There is a lot of ongoing research attempting to identify the root cause of endometriosis and thereby inform endometriosis treatment. However, there is still more work and funding needed in this area. Current theories as to why endometriosis develops include:
- Retrograde menstruation
- Genetics
- Toxins
- Bacterial and dysbiosis hypothesis
- Hormone levels and detoxification
Learn more about what drives endometriosis here.
It is important to remember that in order to truly help someone with endometriosis we have to look at what triggered and drives their endometriosis. This involves looking at what is driving the inflammation and immune dysregulation including microbiomes, triggering infections, toxins levels, genetics and hormones in a lot of detail as some examples. Not simply taking a pill to lower one hormone – estrogen.
Women need better healthcare options and endometriosis needs more research and funding, not another rebranded pill that suppresses our hormones long-term.
What should I do next?
If you are struggling with endometriosis please reach out to our team, we have a team of dedicated women’s health specialists who can help to dive deep into your own personal health picture to help holistically reduce your endometriosis proliferation long-term. You can have some dedicated time 1:1 with a practitioner or look at completing the Advanced Hormone test too.
Read more here about how we address endometriosis at FUTURE WOMAN.
