Is Ryeqo a menopause medication?

Not exactly. Ryeqo is primarily used for fibroids and endometriosis, but because it affects hormone levels, some women experience menopause-like symptom changes while taking it. The add-back hormones in Ryeqo are designed to minimise these effects.

Does Ryeqo stop periods?

For some women, Ryeqo may significantly reduce or stop menstrual bleeding during treatment. In clinical trials, the majority of women experienced a meaningful reduction in menstrual blood loss within the first few months.

Can Ryeqo help endometriosis pain?

Yes. Ryeqo may help reduce hormone-driven inflammation and pain associated with endometriosis by lowering oestrogen levels. Results vary between individuals and it should always be prescribed and monitored by a healthcare professional.

Is Ryeqo a hormone replacement therapy (HRT)?

No. Ryeqo is not standard HRT, although it contains small amounts of oestrogen and progestogen as add-back therapy to help reduce side effects from hormone suppression. It works differently from standard HRT and is prescribed for different conditions.

Can Ryeqo replace surgery?

In some cases, Ryeqo may reduce symptoms enough to delay or avoid surgery. Whether it can replace surgery depends on the severity of the condition and individual response, and should be assessed with a specialist.

Pain Management

Ryeqo for Fibroids and Endometriosis: What Women in the UK Need to Know

TribeTeam

May 22, 2026

Reviewed by Julie Boora, Superintendent Pharmacist, TribElle Health Ltd (GPhC Reg. 9012688)

Women's hormonal health conditions are often underdiagnosed, misunderstood, or dismissed for years before effective treatment is offered. Conditions like fibroids, endometriosis, heavy menstrual bleeding, pelvic pain, and hormone-related symptoms can significantly affect quality of life, work, sleep, fertility, mental health, and relationships.

One medication that is gaining increasing attention in women's healthcare is Ryeqo. Despite being available in the UK and Europe, many women still do not know what it is, how it works, or who it may help.

This guide explains:

→	What Ryeqo is and what it treats

→	How it works

→	Potential benefits and risks

→	The latest evidence-based research

→	Why women should understand this treatment option

What is Ryeqo?

Ryeqo is a prescription medication used to treat:

→	Moderate to severe symptoms of uterine fibroids

→	Endometriosis-associated pain

→	Hormone-related gynaecological symptoms in some women

It combines three active ingredients:

Relugolix

GnRH receptor antagonist

Estradiol

Add-back oestrogen

Norethisterone acetate

Add-back progestogen

Quick answer

Ryeqo reduces the production of hormones that drive fibroid growth and endometriosis symptoms, while replacing small amounts of hormones to reduce side effects such as bone density loss and menopausal symptoms.

Why more women should know about Ryeqo

Many women spend years searching for answers before receiving effective treatment for hormone-related conditions. Symptoms are often normalised or dismissed:

Common dismissed symptoms

Heavy bleeding

Severe period pain

Pelvic pressure and bloating

Pain during sex

Fatigue and fertility challenges

Chronic pelvic pain

Awareness may help avoid

Repeated surgeries

Long-term unmanaged symptoms

Chronic pain progression

Reduced quality of life

Delayed fertility decisions

How Ryeqo works

Ryeqo belongs to a newer class of medications called GnRH receptor antagonists. These reduce the body's production of oestrogen and progesterone — hormones that can worsen fibroid growth, heavy menstrual bleeding, endometriosis lesions, and pelvic inflammation.

However, completely suppressing oestrogen can trigger menopause-like symptoms. To reduce this risk, Ryeqo includes add-back hormone therapy, which helps maintain safer hormone levels while still controlling symptoms. This combined approach aims to balance:

→	Symptom reduction

→	Bone protection

→	Hormonal stability

→	Improved tolerability compared to older hormone suppression treatments

Conditions Ryeqo is commonly used for

Uterine fibroids

Non-cancerous growths in or around the uterus that can cause heavy periods, anaemia, pelvic pressure, urinary symptoms, pain, and fertility problems. Ryeqo may help shrink fibroid-related symptoms and reduce menstrual bleeding.

Endometriosis

Tissue similar to the uterine lining grows outside the uterus, causing severe pain, fatigue, digestive symptoms, chronic inflammation, and fertility issues. Ryeqo may reduce endometriosis-related pain by lowering oestrogen stimulation.

Evidence-based research on Ryeqo

Research into GnRH antagonists has expanded rapidly as clinicians search for alternatives to surgery and long-term unmanaged hormonal symptoms.

Ryeqo clinical evidence — SPIRIT trials

→	The SPIRIT 1 and SPIRIT 2 phase 3 trials demonstrated that relugolix combination therapy significantly reduced heavy menstrual bleeding in women with uterine fibroids compared to placebo. NEJM, 2021

→	Over 70% of women in the relugolix combination group achieved reduced menstrual blood loss, with improvements in anaemia, pain, and quality of life

→	Bone density was better preserved with the add-back combination therapy compared to relugolix alone

Wider context: advances in women's hormonal health

→	Research into modern hormone-regulating medications demonstrates how targeting neurological and hormonal pathways can improve symptom control while reducing reliance on older treatment models. US FDA

→	Clinical studies involving newer women's health therapies have shown improvements in symptom severity, treatment tolerability, and patient-reported quality of life. US FDA

Why women's hormonal health needs more attention

Historically, women's health conditions have faced delayed diagnosis, limited research funding, symptom dismissal, under-treatment, and lack of public awareness. Many women with fibroids or endometriosis wait years before diagnosis — affecting physical health, mental wellbeing, career, relationships, and fertility outcomes.

Improving awareness around medications like Ryeqo helps women have more informed conversations with healthcare professionals and explore treatment pathways earlier — before conditions worsen or fertility is compromised.

Potential benefits of Ryeqo

Depending on the individual and condition being treated, possible benefits may include:

Symptom improvements

✓Reduced heavy bleeding

✓Less pelvic pain

✓Improved daily functioning

✓Reduced need for surgery

✓Better symptom control

Wider wellbeing

✓Better sleep and energy

✓Improved emotional wellbeing

✓Greater confidence

✓Ability to work and exercise

✓Improved quality of life

Important risks and side effects

Like all prescription medications, Ryeqo may not be suitable for everyone. Possible side effects can include:

Possible side effects

⚠

Headaches

⚠	Mood changes

⚠	Hot flushes

⚠	Reduced bone mineral density

⚠	Irregular bleeding

⚠

Nausea

Hormone-modulating medications also require careful medical assessment, particularly in women with certain cardiovascular, liver, clotting, or hormone-sensitive conditions. Treatment decisions should always be personalised and discussed with a qualified healthcare professional.

The future of women's hormonal healthcare

The growing visibility of medications like Ryeqo reflects a wider shift in women's healthcare — towards earlier intervention, personalised medicine, non-surgical treatment options, and long-term quality of life outcomes.

Women are becoming more proactive about understanding perimenopause, endometriosis, fibroids, hormone regulation, and menopause symptom management. This shift is helping reduce stigma around reproductive and hormonal health conversations — and driving demand for better, faster, more informed care.

Frequently asked questions about Ryeqo

Final thoughts from TribElle

Women deserve greater awareness, faster diagnosis, and more treatment choices when managing hormonal health conditions. Understanding how medications like Ryeqo work can help you have more informed conversations with healthcare professionals — and explore treatment pathways that align with your symptoms, goals, and overall wellbeing.