Second Daily Endometriosis Pill Approved for NHS Use in England

A new oral treatment for endometriosis, linzagolix, has been approved for use on the NHS in England, offering a second at-home pill option to help women manage this often-debilitating condition.

Endometriosis affects approximately 1.5 million women in the UK, causing chronic pelvic pain, heavy menstrual bleeding, fatigue, and fertility challenges. The condition occurs when tissue similar to the lining of the womb grows outside the uterus, frequently impacting the pelvic cavity, bladder, and bowel.

Linzagolix will be made available to over 1,000 women who have not responded to other medical or surgical treatments. It works by suppressing hormones such as oestrogen, effectively inducing a reversible, medically managed menopause. Clinical trials have demonstrated its ability to reduce both painful menstruation and non-menstrual pelvic pain compared to placebo.

This is the second daily oral medication for endometriosis now approved by the National Institute for Health and Care Excellence (NICE), following the earlier approval of relugolix combination therapy in March. While both drugs aim to suppress hormone activity to reduce symptoms, linzagolix differs in its formulation: it requires separate “add-back” therapy to offset menopause-like side effects and prevent bone loss. In contrast, relugolix combines both the suppressive and restorative hormones in a single pill.

The NHS list price is £80 for a monthly supply of linzagolix, compared to £72 for a 28-day course of relugolix.

What are the symptoms of endometriosis?

• Severe period pain that interferes with daily life

• Heavy or prolonged menstrual bleeding

• Pain during bowel movements or urination

• Lower abdominal or pelvic pain

• Pain after sexual intercourse

• Fatigue, breathlessness, anxiety, and low mood

• Difficulty conceiving

While there is no known cure for endometriosis, existing treatment approaches include pain management, hormone therapy, and surgery. Hormone injections, for instance, have been widely used to suppress oestrogen production but often require hospital visits and carry systemic side effects.

Linzagolix represents a shift toward more accessible, patient-managed care. As Dr. Sue Mann, National Clinical Director in Women’s Health for NHS England, explains:

“This new option allows women to manage symptoms in the comfort of their own homes, giving them more control and improving quality of life.”

Baroness Merron, Minister for Women’s Health, welcomed the approval, calling it a “game-changer” for thousands navigating a condition that is “both debilitating and life-limiting.”

Emma Cox, CEO of Endometriosis UK, emphasised the significance of this development:

“There are still far too few treatment options available due to the historic underfunding of endometriosis research. NICE’s approval of linzagolix is an encouraging step forward, and we urge all UK nations to ensure access to this medication.”

In line with NICE guidance, the Welsh Government has already instructed the NHS in Wales to make linzagolix available within 60 days.

As awareness grows and research deepens, expanded treatment options like linzagolix reflect a crucial evolution in endometriosis care—centring patients, broadening access, and acknowledging the daily realities of living with this chronic condition.