Endometriosis Treatment Is Changing. Is It Time to Revisit Your Options?

Perhaps you were prescribed the pill years ago and have stayed on it ever since. Perhaps surgery helped for a while, but the pain returned. Or perhaps you stopped asking about treatment because every conversation seemed to end with the same choices.

When you have lived with endometriosis for a long time, managing symptoms can become part of the background of life. You know which days are likely to be difficult, carry medication everywhere and quietly arrange work, relationships and social plans around the pain.

But a treatment plan that was agreed several years ago does not have to remain unchanged forever. New options have become available, and changes in your symptoms, priorities or circumstances can also be reasons to ask for a review.

Recent reporting has highlighted women describing substantial relief from newer oral treatments. Those experiences offer hope, although they do not mean the medicines will suit everyone or that endometriosis now has a cure.

What has changed?

During 2025, NICE published guidance recommending two additional oral treatment options for eligible adults of reproductive age with endometriosis: relugolix–estradiol–norethisterone, known as Ryeqo, and linzagolix, known as Yselty. These were additions to the available treatment choices, rather than replacements for every existing approach.

These medicines suppress hormonal signals involved in endometriosis symptoms. Relugolix combination therapy includes hormonal “add-back” treatment in the same tablet, while linzagolix is used with add-back therapy. The additional hormones help limit some effects of hormone suppression, including menopausal symptoms and bone loss. Clinical evidence reviewed by NICE found that linzagolix with add-back therapy reduced painful periods and pelvic pain occurring outside periods.

For someone who has struggled with previous treatments, an oral option may be worth discussing. However, eligibility, previous treatment, medical history, side effects and monitoring all need consideration. Availability and prescribing arrangements can also differ across the UK.

The useful question is not simply, “Can I have the newest medicine?” It is, “Given what I have already tried and how I am feeling now, what options are appropriate for me?”

When is a treatment review worth asking for?

You do not need to wait until symptoms become unbearable. A review may be worthwhile if pain is breaking through your current treatment, side effects are difficult to tolerate or you are increasingly changing your life to accommodate symptoms.

Perhaps you are missing shifts, avoiding sex, waking through the night or cancelling plans. You may still be getting everything done, but only by using most of your energy to manage discomfort.

Our article, “The Period Pain Test: If You Have to Plan Your Life Around It, Why Are You Being Told It’s Normal?”, explores why the effect on daily life matters when seeking help.

The NHS advises seeing a GP if symptoms affect everyday life, work or relationships, or if treatment has not helped or symptoms have worsened. Returning for advice is a reasonable response to an unmet health need.

New tests and new treatments are different developments

Alongside changes in treatment, there is considerable interest in improving diagnosis. Readers may also have seen our coverage of new endometriosis tests.

It is important to distinguish a test’s approval or commercial availability from its place in routine NHS care. A headline about a new test does not automatically mean it is available through your GP or suitable as a replacement for existing investigations.

If you are still waiting for answers, ask what investigation is appropriate for your symptoms and what happens next if the result is normal. The Royal College of Obstetricians and Gynaecologists states that a normal ultrasound or MRI does not rule out endometriosis.

You can also ask what symptom relief is available while assessment continues.

Your priorities should shape the conversation

A treatment that once suited you may no longer fit your life. You may now want to try for a baby, need contraception, have developed another health condition or feel differently about surgery.

Tell your clinician what matters most to you. That could be reducing pain enough to work comfortably, improving sleep, avoiding particular side effects or discussing fertility.

Pregnancy plans are especially important because hormonal treatments used to suppress endometriosis symptoms are not appropriate while trying to conceive. Ask about the specific medicine’s contraception requirements and how treatment would be reviewed if your plans change. Endometriosis does not mean everyone will have fertility difficulties, but concerns deserve an individual discussion.

Surgery may still be part of the discussion

The arrival of more medicines does not remove the role of surgery. Depending on symptoms, the location of endometriosis and your preferences, surgery may still be considered.

Equally, having had an operation does not mean there is nothing further to discuss if symptoms persist or return. Ask what may be contributing to the pain now and whether specialist review would help.

Support may also include help with persistent pain, fatigue, fertility concerns and emotional wellbeing. A treatment plan can address several needs rather than relying on one prescription or procedure to resolve everything.

Make the next appointment specific

Before a review, write down your current treatment, what you have previously tried, what helped and why anything was stopped. Add a few examples of how symptoms affect your life now.

You could ask: “Are there options I have not tried?”, “Would either of the newer oral treatments be appropriate?”, “What side effects or monitoring would be involved?” and “When should we review whether this is working?”

If a treatment is unsuitable, ask why and what the alternative plan is. Before leaving, try to establish the next step and who to contact if symptoms worsen.

You do not have to arrive knowing which medicine you need. You deserve a conversation that takes account of how you are living now, rather than assuming an old treatment plan is still doing enough.

This article provides general health information and is not a substitute for personalised medical advice. Do not stop or change prescribed treatment without speaking to your clinician. Seek urgent medical help for sudden severe pelvic pain, collapse or heavy bleeding accompanied by feeling faint or unwell.