This is general health information only and is not a substitute for advice from your GP or healthcare professional.
1. What is Ryeqo?
Ryeqo is a prescription medicine containing relugolix, estradiol and norethisterone acetate. It is used to treat moderate to severe symptoms associated with uterine fibroids and endometriosis in appropriate patients. It combines suppression of ovarian hormone production with low-dose “add-back” hormone therapy.
2. How does Ryeqo work?
Relugolix is an oral GnRH receptor antagonist that rapidly suppresses ovarian production of oestrogen and progesterone. This can reduce fibroid-related heavy menstrual bleeding and endometriosis-associated pain. Estradiol provides a low dose of oestrogen to reduce symptoms associated with excessive oestrogen suppression, while norethisterone acetate protects the lining of the uterus from the effects of oestrogen.
3. What symptoms can Ryeqo treat?
For uterine fibroids, Ryeqo can reduce heavy menstrual bleeding and associated symptoms. For endometriosis, it can reduce endometriosis-associated pain, including painful periods and pelvic pain. It does not remove fibroids or endometriotic lesions but reduces the hormonal stimulation that contributes to their symptoms.
4. How is Ryeqo taken?
Ryeqo is taken as one tablet once daily, preferably at approximately the same time each day, with or without food. It is intended for continuous treatment. Consistent daily dosing is important because interruption can allow ovarian hormone activity to recover.
5. Does Ryeqo stop ovulation and provide contraception?
Ryeqo is not officially indicated as a contraceptive, although relugolix suppresses ovulation in most women after approximately one month of continuous treatment. Non-hormonal contraception, such as condoms, should therefore be used during the first month of treatment and as otherwise advised by your doctor. Standard hormonal contraceptives, including combined oral contraceptives, should not be used together with Ryeqo unless specifically directed by a specialist, because additional hormonal contraception can interfere with the intended treatment and may increase hormonal exposure.
6. Does Ryeqo stop menstruation?
Ryeqo commonly reduces menstrual bleeding and may cause periods to become very light or stop completely. Irregular or breakthrough bleeding can occur, particularly during the first few months. Reduced menstrual bleeding is an expected therapeutic effect when Ryeqo is being used for heavy bleeding associated with uterine fibroids.
7. What are the common side effects of Ryeqo?
Possible side effects include headache, hot flushes, sweating, mood changes, reduced libido, acne, hair loss and abnormal uterine bleeding. Some women may also experience breast discomfort or abdominal symptoms. Side effects related to suppression of ovarian hormones may be more noticeable when treatment is first started.
8. Can Ryeqo affect bone density?
Yes. Suppression of ovarian oestrogen can reduce bone mineral density. The estradiol component provides “add-back” therapy to help minimise this effect, but bone health remains an important consideration. Ryeqo may not be appropriate for women with osteoporosis or significant risk factors for bone loss, and treatment duration should be regularly reviewed.
9. Who should not take Ryeqo?
Ryeqo is contraindicated in pregnancy and in women with certain conditions, including current or previous hormone-dependent cancers such as breast cancer, uncontrolled hypertension, severe liver disease, and active or previous significant venous or arterial thromboembolic disease, depending on the specific clinical circumstances. It also has important interactions with medicines that strongly affect CYP3A4, P-glycoprotein, or related drug-metabolising pathways. Your doctor should review your medical history and medications before treatment.
10. When should I seek urgent medical attention while taking Ryeqo?
Seek urgent medical attention if you develop symptoms of a blood clot, such as sudden chest pain, shortness of breath, coughing blood, or painful swelling of one leg. Prompt assessment is also required for severe abdominal pain, jaundice, a severe allergic reaction, or significant unexpected vaginal bleeding. Regular medical review is important to monitor symptom response, blood pressure, cardiovascular risk, and bone health.