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Remember, this is educational information only and not medical advice – always check with your qualified medical professional before making any changes to your treatment plan for endometriosis or any other health problems.
Orilissa and GnRh antagonists
Some new medications have been introduced onto the market in the past few years:
- 2018 – Orilissa by Abbvie: generic name elagolix
- 2022 – MyFembree by Myovant/Pfizer: generic name relugolix
- 2022 – Yselty by ObsEva: generic name linzagolix
It’s symptom management only
It can have serious side effects
It’s not your only option
In summary
- GnRh drugs don’t do anything to the endometriosis itself like shrink it or dry it up.
- Endometriosis can still progress while you’re on GnRh drugs.
- Various studies comparing GnRh drugs to other hormonal medications show these all to provide similar symptom relief.
- GnRh drugs are supposed to be second-line treatments, prescribed when first-line hormones like contraceptive pills, progestin shots, IUDs, etc are ineffective, not tolerated or contraindicated.
- GnRh drugs have a higher side effect profile than first-line treatments, and you can’t be on them as long.
- GnRh antagonists are new and we don’t have data on potential long-term side effects.
Is this the best option for me?
That’s something that only you can decide after doing ample research on Orilissa. I put together a lot of detailed information in my podcast episodes below on the efficacy and risks of Lupron and Orilissa, so please check that out!
The only way to actually treat endometriosis is excision surgery and removing the disease at the root. However, not everyone can access excision surgery and we need a way to reduce our symptoms and improve our quality of life. Orilissa only helps some people with lowering their endometriosis symptoms while they are taking the drug, and it’s considered a “band aid” because it’s only temporary, and once the person stops the drug, their endometriosis symptoms typically come back quite quickly.
With any treatment or management option, we should assess if the benefits outweigh the risks. Some helpful questions we can ask ourselves are:
- What other options do I have? (Excision surgery, diet and lifestyle changes, other hormonal medications such as the IUD, progestins, and birth controls which have a lower side effect profile and provide similar pain relief to Orilissa.)
- What options have I already tried?
- What risks are there to this medication vs the other options?
- Is my doctor an actual endometriosis specialist?
It can be hard to make choices about our endometriosis care. Between the misinformed doctors, to the difficulty of accessing a true specialist, to the daily symptoms which make everything 10 times harder, it can be difficult to gather all the facts to make a fully informed decision. We should be given all the facts and options from the start when we go to the doctor for endometriosis care, but unfortunately that typically doesn’t happen and a heavy burden falls on our shoulders to educate and advocate for ourselves. Which is unfair and exhausting.
Sometimes we judge ourselves, or others judge us, for the choices we make about our care, but there shouldn’t be any judgement on our decision choices, especially from other people! Whatever choices you make for yourself are based on what you think is best at the time, and that’s all we can do for ourselves: gather information and make a decision based on it. We don’t know how we will respond to a certain treatment, and we are all making the best decisions that we can based on our personal risk/benefit analysis as individuals.
For More Info
- Endometriosis: Report-at-a-Glance – Report on Orilissa by ICER. “The Institute for Clinical and Economic Review (ICER) is an independent nonprofit research institute that produces reports analyzing the evidence on the effectiveness and value of drugs and other medical services.”
- OrilissaTM, a “significant advancement” for endometriosis patients – or another obstacle to quality care? – Article from Endo What.
- Elagolix for endometriosis: all that glitters is not gold. Paolo Vercellini, Paola Viganò, Giussy Barbara, Laura Buggio, Edgardo Somigliana, ‘Luigi Mangiagalli’ Endometriosis Study Group, Human Reproduction, Volume 34, Issue 2, February 2019, Pages 193–199, https://doi.org/10.1093/humrep/dey368
- Hormonal Therapy in Women of Reproductive Age with Endometriosis: An Update. – 2019 research article by Gheorghisan-Galateanu AA, Gheorghiu ML. Acta Endocrinol (Buchar). 2019;15(2):276-281. doi:10.4183/aeb.2019.276
- Endometriosis and Medical Therapy: From Progestogens to Progesterone Resistance to GnRH Antagonists: A Review – 2021 research article by Donnez J, Dolmans MM. J Clin Med. 2021;10(5):1085. Published 2021 Mar 5. doi:10.3390/jcm10051085
Related Podcast Episodes
- Ep 30 – Orilissa and Lupron. Part 1 – Misconceptions and Marketing
- Ep 31 – Orilissa and Lupron. Part 2A – How Effective is Orilissa?
- Ep 37 – Orilissa and Lupron. Part 3 – Side Effects
- Ep 91 – What Can Hormonal Suppression Actually Do For Endometriosis?
- Ep 92 – Hormonal Medication Options for Endometriosis