Last reviewed 24 May 2022

The National Institute of Health and Care Excellence (NICE) has advised that a new oral tablet could be offered to thousands of women with fibroids to help avoid invasive surgery.

About 4500 women with uterine fibroids will be eligible for the new oral treatment in England and Wales, and it should become available within the next few months after NICE’s final guidance has been published.

NICE said relugolix with estradiol and norethisterone acetate, also called Ryeqo, should be added to the treatment options considered if a woman has moderate to severe symptoms, which include heavy or painful periods, abdominal pain, lower back pain, frequent need to urinate, constipation, pain or discomfort during sex and bloating.

Ryeqo tablets, made by Gedeon Ritcher UK, are designed to be taken daily at home to help control symptoms. Comprising 40mg relugolix, 1mg estradiol and 0.5mg norethisterone acetate, it works by reducing the release of hormones which control oestrogen and progesterone production by the ovaries. Research has suggested that they can be used in the long term and should not affect fertility.

NICE Centre for Health Technology Evaluation Interim Director of Medicines Evaluation Helen Knight said: "This treatment has the potential to improve quality of life. As well as effectively reducing symptoms, it can be taken at home and is therefore more convenient than the injectable treatment, given in a hospital setting. It can also be used long term, which could mean improved and sustained symptom relief, it is well-tolerated, and it will mean thousands of women can avoid invasive surgery which always carries some risk."

Minister for Women’s Health Maria Caulfield added that it was another “ground-breaking” step forward to not only improve women’s quality of life and reduce symptoms, but to give them greater choice in the medication available and options for alternative, less invasive treatment.

She confirmed that later this year the first ever Women’s Health Strategy will be published to address closing the gender health gap, so women “can live healthier, happier lives”.

More information about the new final draft guidance is available at