Fibroids and endometriosis – New medical management with Ryeqo (Relugolix)
Fibroids and endometriosis are two common gynaecological conditions that can cause significant discomfort, heavy bleeding, and reduced quality of life. While traditional treatment options have often involved surgery or long-term hormonal therapies, a newer medical treatment - Ryeqo (Relugolix combination therapy) - offers an effective non-surgical option for many women. This once-daily oral medication is now available in the UK and represents a modern shift in how these conditions can be managed.
What is Ryeqo and how does it work?
Ryeqo is a medication that combines Relugolix, which is a gonadotropin-releasing hormone (GnRH) receptor antagonist, and two hormonal add-back components—oestradiol and norethisterone acetate. It’s designed to:
- Reduce the production of oestrogen and progesterone, which fuel fibroid and endometrial tissue growth
- Minimise menopause-like side effects by maintaining low but stable hormone levels
- Provide symptom control without the need for injections or surgical intervention
Ryeqo is taken once daily and begins working quickly, with many patients noticing symptom relief within weeks.
How does Ryeqo help manage fibroids?
Uterine fibroids are non-cancerous growths that develop in or around the uterus. They can cause:
- Heavy or prolonged menstrual bleeding
- Pelvic pain or pressure
- Bladder or bowel symptoms
- Fertility difficulties
Ryeqo can help reduce fibroid symptoms by:
- Significantly lowering menstrual bleeding volume
- Reducing fibroid size in some cases
- Improving quality of life by relieving pressure symptoms and pain
Clinical trials have shown that a large percentage of women with fibroids experience meaningful reductions in bleeding with Ryeqo, without requiring surgery.
How is Ryeqo used in endometriosis treatment?
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, leading to inflammation, pain, and scarring. Common symptoms include:
- Severe pelvic or menstrual pain
- Pain during intercourse
- Bowel or bladder discomfort
- Fertility issues
Ryeqo helps by:
- Suppressing the hormones that trigger endometrial tissue growth
- Reducing pain and inflammation
- Offering a continuous, non-invasive treatment approach
It provides an alternative to injectable GnRH analogues, which can cause strong menopausal side effects and are typically used for short durations only.
What are the benefits of Ryeqo?
- Oral, once-daily dosing
- Fewer menopausal symptoms compared to older hormonal treatments
- Can be used long-term under medical supervision
- Suitable for women who want to delay or avoid surgery
- Shown to improve physical and emotional wellbeing
Are there any risks or side effects?
While Ryeqo is generally well tolerated, some women may experience:
- Headaches or mood changes
- Irregular bleeding initially
- Hot flushes (milder than with other GnRH treatments)
- Bone density changes over long periods—monitoring is advised
It isn’t suitable for women trying to conceive and may not be appropriate in cases of hormone-sensitive conditions or certain cardiovascular risk factors.
Who should consider Ryeqo?
Ryeqo is suitable for women with moderate to severe symptoms of fibroids or endometriosis who:
- Prefer a non-surgical approach
- Have not responded well to other medical treatments
- Are seeking longer-term symptom control
- Are not planning pregnancy in the immediate future
A consultation with a gynaecologist can help determine if Ryeqo is the right option based on individual symptoms and health status.