New Daily Oral Medication for Endometriosis Soon Available on the NHS: How Linzagolix Works

A new oral medication for endometriosis has received recommendation from the National Institute for Health and Care Excellence (NICE), paving the way for its availability on the NHS. The drug, linzagolix, offers a promising new treatment option for women suffering from this often debilitating condition, especially those who have not found relief through existing therapies.

Endometriosis affects approximately 1 in 10 women of reproductive age. It involves the abnormal growth of the uterine lining (endometrium) outside the uterus, commonly in the pelvis, bladder, and bowel. This growth leads to diverse and severe symptoms such as painful, heavy periods, pelvic pain between periods, pain during urination or bowel movements, painful intercourse, fatigue, and infertility. Notably, up to half of women diagnosed with endometriosis experience challenges conceiving.

Despite the significant impact, endometriosis remains without a cure. Current treatments, including painkillers, hormonal contraceptives, and surgical removal of lesions, are often insufficient or unsuitable for many women due to side effects or medical contraindications.

Since the growth of endometrial tissue is driven by the hormone estrogen, reducing estrogen levels can help alleviate symptoms. Linzagolix, a gonadotropin-releasing hormone (GnRH) antagonist, works by suppressing estrogen production. It achieves this by blocking GnRH receptors in the pituitary gland, preventing the release of FSH and LH, hormones that stimulate estrogen production in the ovaries. The result is a state similar to menopause, reducing endometrial growth and associated symptoms.

Clinical trials have demonstrated linzagolix's effectiveness in reducing pain, particularly during menstruation and pelvic discomfort. The greatest benefits were observed in doses of 75 mg or higher, with significant improvements seen from 12 weeks onward, continuing or improving at 24 and 52 weeks.

One potential concern with linzagolix is bone mineral density loss due to lowered estrogen levels. This risk was mainly associated with higher doses (200 mg), where patients might need hormone replacement therapy (HRT) to mitigate bone loss and manage menopausal symptoms. However, HRT is not suitable for everyone, particularly those with certain medical conditions.

Linzagolix will be prescribed mainly for women who have not responded to other hormonal treatments or surgery. It is notable as the second take-home pill for endometriosis treatment to be approved by NICE, with relugolix, a similar drug with built-in HRT, having been approved earlier. Compared to GnRH agonists, which fully suppress estrogen and cause more side effects like hot flushes and loss of libido, linzagolix offers a more tailored, milder suppression with fewer adverse effects, and it is taken orally rather than via injection.

The drug's reversibility is another advantage; estrogen production typically returns quickly after stopping treatment. Common side effects include hot flushes, especially at higher doses, and potential bone density loss requiring add-back HRT.

Endometriosis remains a condition with limited treatment options, and the approval of linzagolix brings new hope. This medication could improve the quality of life for millions of women by providing an effective, manageable, and reversible treatment option.

Source: https://medicalxpress.com/news/2025-05-endometriosis-daily-pill-symptoms-nhs.html