Orilissa is the first oral endometriosis medication that uses a gonadotropin-releasing hormone (GnRH) antagonist for the management of moderate to severe pain. This recently FDA-approved medicine indirectly prevents estrogen production, which is the main driver of endometriosis.
Estrogen is produced by the ovaries when signaled by GnRH from the hypothalamus, which is triggered by the pituitary gland. Put simply, Orilissa blocks the formation of GnRH. With a significant decrease in GnRH in the body, the ovaries also decrease their production of estrogen. As a result, endometriosis growth — and the associated pain — is reduced.
A study by Healio Internal Medicine reported that Orilissa reduces menstrual pain, nonmenstrual pelvic pain and painful intercourse during the six months of treatment and for an additional six months after.
The First Step Is Diagnosing Endometriosis
Science Direct reports that endometriosis affects 10 to 15 percent of reproductive-aged women. They may suffer endometriosis-related pelvic pain for six to 12 years before receiving an accurate diagnosis and treatment. This is often due to a lack of understanding of the complexity of endometriosis symptoms and misconceptions about what is considered normal for a menstrual period.
To uncover the signs that can lead to treatment like an endometriosis medication, a physician must know the right types of questions to ask and the correct kind of imaging technology to use. Diagnosing endometriosis can be streamlined with the help of ultrasound, particularly when 3D transvaginal ultrasound and color Doppler are used.
Ultrasound provides a fast and effective method of assessing the female pelvic organs, while also being inexpensive and radiation-free. It can detect the presence of an ovarian endometrioma, small nodules in the vaginal and bowel wall, or adhesions between the uterus and surrounding tissues — all of which indicate endometriosis.
Patients That May Benefit From Orilissa
Understanding the other endometriosis medication options available will provide a clear idea of which women suffering from endometriosis would be good candidates for this medication.
Mild to moderate endometriosis-related pain is often treated with birth control pills, anti-inflammatory medications and intrauterine devices containing progesterone. People with more severe endometriosis pain may choose a Lupron injection, which fully suppresses estrogen production and also causes an onset of extreme menopause-like symptoms. Surgery is another option, either to remove endometrial deposits or have a complete hysterectomy.
The women who would benefit from this medication most likely have moderate to severe endometriosis-related pain, have not found relief from standard treatments, do not want to undergo surgery and do not want to risk severe side effects, such as those from the injectable drug treatment. These women would not be trying to become pregnant, and they would be over 18 years of age.
Potential Side Effects
Endometriosis News reported that the Orilissa clinical trials of more than 1,600 women, who were followed for a year and didn't experience any severe negative reactions, have received praise. The most common side effect in those trials was mild hot flashes.
The medication's website notes that there is the possibility of side effects such as nausea, absence of periods, anxiety, joint pain, depression and mood changes. There can also be a decline in bone mineral density, with the loss becoming greater with increased duration of use. For this reason, recommended use is limited to two years for the low dose and six months for the high dose.
What This Endometriosis Treatment Can Mean for Women
A relatively simple treatment of two pills a day, Orilissa is the first oral medication for moderate to severe endometriosis pain. Although it is not a cure, it can be viewed as a better option for many young women with disabling pain who are faced with surgery or suffering each month until menopause brings a natural decline in their estrogen production.
While endometriosis is a very common disease, it is also complex and many patients are inadequately cared for. Part of effective treatment is accurate diagnosing, which can be accomplished with the use of 3D transvaginal ultrasound to thoroughly assess the pelvis and reproductive organs for indications of endometriosis. Furthermore, having access to an effective endometriosis medication will provide a much-needed boost to the standard of living for many women.