Volume 30, Issue 172, June 2026

Gonadotropin-releasing hormone antagonism treatment of endometriosis - new perspectives

Katarzyna Markuszka^1♦, Kinga Polityńska¹, Klaudia Samuła¹, Martyna Sarzyńska¹, Mateusz Szabat², Sylwia Lepak¹, Zuzanna Irzyk¹, Dominika Ruszel¹, Emilia Goc¹, Julia Rogała¹

¹Faculty of Medicine, University of Rzeszów, Rzeszów, Poland.
²Clinical Provincial Hospital No. 2, Rzeszów, Poland

^♦Corresponding author
Katarzyna Markuszka, Faculty of Medicine, University of Rzeszów, Rzeszów, Poland

ABSTRACT

Endometriosis is an inflammatory, estrogen-dependent disorder that affects women of reproductive age. Pain management continues as a challenge as there has been limited progress in this area; however, oral GnRH antagonists are proving to be potent, safe, and well-tolerated options. The objectives of this paper were to evaluate the efficacy. and tolerability of the GnRH antagonists (relugolix, elagolix, linzagolix) for pain associated with endometriosis, and to determine their effects on patients' occupational functioning. Researchers analyzed patient-reported outcomes, adherence, and the long-term benefits of these drugs in light of the need for individualized therapies. To be eligible, patients had to have at least one of the following endpoints: pain reduction, safety profile, or impact on occupational functioning. Phase III clinical trials demonstrated that combination therapy with relugolix significantly reduced the severity of dysmenorrhea and non-menstrual pelvic pain compared with placebo. Researchers showed that relugolix is as effective as leuprorelin. However, relugolix has a better safety profile. Patients experienced fewer vasomotor symptoms and lower bone mineral density loss. Studies also demonstrated that elagolix improved work performance. It reduced absenteeism and presenteeism, which resulted in financial benefits for both employers and patients. GnRH antagonists are an effective and safe therapeutic option for the treatment of endometriosis-associated pain. In addition to improving clinical outcomes, their use has been shown to improve occupational functioning significantly. These therapies may play a key role in the long-term, individualized management of endometriosis, offering an alternative to traditional hormonal and surgical treatments and consequently broadening therapeutic options.

Keywords: endometriosis, relugolix, linzagolix, elagolix, GnRH antagonist

Medical Science, 2026, 30, e114ms3857

PDF

DOI: https://doi.org/10.54905/disssi.v30i172.e114ms3857

Published: 29 June 2026