Women who suffer from fibroids will now be able to take an oral tablet that could help them avoid invasive surgery.
Ryeqo pills should be added to the treatment options considered if a woman has moderate to severe symptoms of fibroids, the National Institute of Health and Care Excellence (NICE) has ruled.
These symptoms include heavy and painful periods and bloating that makes a woman look pregnant.
NICE says that around 4,500 women with uterine fibroids will be eligible for the pills in England and Wales when they become available in three months.
Designed to be taken daily at home, the Ryeqo tablet combines several different medications – relugolix with estradiol and norethisterone acetate – to control symptoms. Tests suggest they are be safe to be take on an ongoing basis without affecting a woman’s fertility.
Maria Caulfield, minister for women’s health, called it “a 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.”
What are fibroids?
As Dr Deborah Lee, a sexual and reproductive healthcare doctor from Dr Fox Pharmacy previously explained to HuffPost UK, fibroids are “benign tumours of small muscle which arise in the wall of the uterus (womb). Each fibroid grows from one individual muscle cell, which grows out of control. As the fibroid enlarges, it presses on any surrounding structures.”
While non-cancerous, fibroids can sometimes lead to infertility and they affect one in three women in their lifetime, the NHS says, with Black women are disproportionately impacted.
Nearly a quarter of Black women between 18 and 30 have fibroids compared to about 6% of white women, according to some estimates. And by age 35, that number increases to 60%.
Despite this, many Black women report it taking months – and in some cases, years – for their symptoms to be taken seriously be medical professionals.
What are the signs of fibroids?
Heavy menstrual bleeding
Painful sex
Lower back pain
Abdominal distension (when the abdomen is swollen outwards)
Fatigue
Inter-menstrual bleeding (bleeding between periods)
Fatigue
Urinary symptoms (such as frequent urination or incontinence)
Why is this new so pill important?
The oral tablet will limit how many women need surgery and help them deal with their symptoms. This could be a gamechanger in particular for the many Black women who suffer with fibroids and struggle to get surgery to remove them.
Rasheedat Olarinoye, a 25-year-old civil servant from Slough, recently had a myomectomy to remove her fibroids.
It took nine months for her to be diagnosed, and her fibroids got so big, she says she looked six or seven months pregnant.
At first she thought it could be something to do with her digestion. She didn’t link her stomach issues to her periods, even though she would have painful cramps and often bleed for up to 10 days.
“Uterine fibroids can have a profound effect on quality of life. Along with the many debilitating symptoms, there is a real lack of long-term options,” said Helen Knight, interim director of medicines evaluation in the NICE Centre for Health Technology Evaluation, when announcing the new pill.
“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.”
Why are Black women more likely to have fibroids?
As Dr Lee previously explained to HuffPost UK, fibroids are sensitive to oestrogen and Black women more commonly possess a specific oestrogen receptor known as the oestrogen receptor-α PP variant, which has also been linked to the presence of fibroids.
“Some research suggest fibroids may be linked to vitamin D deficiency, and Black women are more likely to vitamin D deficient than white women,” she added. “Vitamin D is an essential vitamin for bone health but it also plays a vital role in regulating the immune system.”
Black women’s health concerns not being taken seriously due to structural racism is also a factor in low diagnosis rates, Lee stressed. “In a shockingly recent 2016 study of first and second-year medical students, nearly half believed that Black skin was thicker than white skin and that Black people did not feel so much pain as white people,” she added.