A new daily tablet for endometriosis, called linzagolix (also known as Yselty), has been approved for use on the NHS and is expected to help up to 1,000 women each year. But what exactly is endometriosis, and how can you tell if you might have it? 

Endometriosis is a long-term condition with no known cure, affecting roughly 1 in 10 women. It occurs when tissue similar to the lining of the womb grows in other parts of the body. These cells respond to hormonal changes during the menstrual cycle, which can cause pain, inflammation, and the formation of scar tissue.

The approval of linzagolix follows the green light from NICE (National Institute for Health and Care Excellence) in March for another long-term treatment — relugolix combination therapy, also known as Ryeqo. However, diagnosis remains a significant challenge, with the average time from symptom onset to diagnosis being around nine years, according to Surrey Live.

Linzagolix works by blocking specific hormones that contribute to the symptoms of endometriosis. The main symptoms of endometriosis can include:

• painful periods
• back pain
• pain that radiates down the thigh and leg
• heavy menstrual bleeding
• pelvic pain
• irregular periods
• pain during or after intercourse
• pelvic pain when either passing urine or opening the bowel
• fatigue
• difficulty getting pregnant

Symptoms and pain levels can differ between individuals as whilst some may have only mild discomfort, others suffer from intense, debilitating pain that can keep them in bed for days. Fatigue is also a common but often overlooked symptom of endometriosis, so if you’re feeling persistently tired despite getting plenty of rest, it could be related to the condition.

Helen Knight, director of medicines evaluation at Nice, said: “We’re pleased to recommend linzagolix as a new treatment option for endometriosis. As a once-daily tablet taken at home, it offers a convenient way for people with endometriosis to manage their condition and helps to ease pressure on NHS services. Thanks to our streamlined process, we’ve been able to fast-track our evaluation of this treatment to get it to the people who need it, quickly. Linzagolix is a valuable addition to the options available for this often painful and disruptive condition.”

Linzagolix is administered as a 200mg tablet taken once a day and must be combined with separate hormonal “add-back” therapy—low-dose hormone replacement therapy designed to minimise menopause-like side effects and prevent bone density loss.

Clinical trials have demonstrated that linzagolix helps to alleviate menstrual pain and non-menstrual pelvic discomfort when compared to a placebo. While already approved for treating uterine fibroids, Linzagolix is aimed at patients with endometriosis who have not achieved relief from previous medical or surgical treatments.

Dr Sue Mann, national clinical director in women’s health at NHS England, said: “This is welcome news for women with endometriosis who haven’t found relief from previous therapies or surgery – it’s another treatment option which will help women take control of their health and better manage the symptoms of this often painful and debilitating condition.

“This is a testament to our ongoing commitment to improving treatment, care and quality of life for women – and follows the approval just months ago of the first long-term daily pill for managing endometriosis on the NHS, giving women more choice in treatment they can take in the comfort of their own homes.”

Women’s health minister, Baroness Merron, said: “This could be a game-changer for thousands of women battling endometriosis, which can be a debilitating and life-limiting condition. After years of neglect in women’s health, we are turning the tide – backing new treatments like linzagolix, cutting diagnosis times and slashing waiting lists.”