For women diagnosed with endometriosis it is often a long sentence of chronic pain and cramping that impacts their daily life. It is a condition that is both difficult to diagnose and treat, with many women needing either surgery or regular medication.

A medicine called Ryeqo has just been approved for marketing specifically for endometriosis, although it was already available in Australia to treat a different condition.

Women who want the drug will need to consult their local doctor and, as it is not yet on the Pharmaceutical Benefits Scheme, they will need to pay the full cost of the script.

What does Ryeqo do?

Endometriosis affects 14% of women of reproductive age. While we don’t have a full understanding of the cause, the evidence suggests it’s due to body tissue that is similar to the lining of the uterus (called the endometrium) growing outside the uterus. This causes pain and inflammation, which reduces quality of life and can also affect fertility.

Ryeqo is a tablet containing three different active ingredients: relugolix, estradiol and norethisterone.

Relugolix is a drug that blocks a particular peptide from releasing other hormones. It is also used in the treatment of prostate cancer. Estradiol is a naturally occurring oestrogen hormone in women that helps regulate the menstrual cycle and is used in menopausal hormone therapy. Norethisterone is a synthetic hormone commonly used in birth control medications and to delay menstruation and help with heavy menstrual bleeding.

All three components work together to regulate the levels of oestrogen and progesterone in the body that contribute to endometriosis, alleviating its symptoms.

Relugolix reduces the overall levels of oestrogen and progesterone in the body. The estradiol compensates for the loss of oestrogen because low oestrogen levels can cause hot flushes (also called hot flashes) and bone density loss. And norethisterone blocks the effects of estradiol on the uterus (where too much tissue growth is unwanted).

Is it really new?

The maker of Ryeqo claims it is the first new drug for endometriosis in Australia in 13 years.

But individually, all three active ingredients in Ryeqo have been in use since 2019 or earlier.

Ryeqo has been available in Australia since 2022, but until now was not specifically indicated for endometriosis. It was originally approved for the treatment of uterine fibroids, which share some common symptoms with endometriosis and have related causes.

In addition to Ryeqo, current medical guidance lists other drugs that are suitable for endometriosis and some reformulations of these have also only been recently approved.

The oral medicine Dienogest was approved in 2021, and there have been a number of injectable drugs for endometriosis recently approved, such as Sayana Press which was approved in a smaller dose form for self-injection in 2023.

How to take it and what not to do

Ryeqo is a once-a-day tablet. You can take it with, or without food, but it should be taken about the same time each day.

It is recommended you start taking Ryeqo within the first five days after the start of your next period. If you start at another time during your period, you may experience initial irregular or heavier bleeding.

Because it contains both synthetic and natural hormones, you can’t use the contraceptive pill and Ryeqo together. However, because Ryeqo does contain norethisterone it can be used as your contraception, although it will take at least one month of use to be effective. So, if you are on Ryeqo, you should use a non-hormonal contraceptive – such as condoms – for a month when starting the medicine.

Ryeqo may be incompatible with other medicines. It might not be suitable for you if you take medicines for epilepsy, HIV and AIDS, hepatitis C, fungal or bacterial infections, high blood pressure, irregular heartbeat, angina (chest pain), or organ rejection. You should also not take Ryeqo if you have a liver tumour or liver disease.

The possible side effects of Ryeqo are similar to those of oral contraceptives. Blood clots are a risk with any medicine that contains an oestrogen or a progestogen, which Ryeqo does. Other potential side effects include bone loss, a reduction in menstrual blood loss or loss of your period.

It’s costly for now

Ryeqo can now be prescribed in Australia, so you should discuss whether Ryeqo is right for you with the doctor you usually consult for your endometriosis.

While the maker has made a submission to the Pharmaceutical Benefits Advisory Committee, it is not yet subsidised by the Australian government. This means that rather than paying the normal PBS price of up to A$31.60, it has been reported it may cost as much as $135 for a one-month supply. The committee will make a decision on whether to subsidise Ryeqo at its meeting next month.

Correction: this article has been updated to clarify the recent approval of specific formulations of drugs for endometriosis.

Nial Wheate, Associate Professor of the School of Pharmacy, University of Sydney and Jasmine Lee, Pharmacist and PhD Candidate, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Everyone seems to have a different opinion when it comes to how often towels and bed sheets should be washed. While many people might wonder whether days or weeks is best, in one survey from the United Kingdom, almost half of single men reported not washing their sheets for up to four months at a time.

It’s fairly clear that four months is too long to leave it, but what is the ideal frequency?

Bed linen and towels are quite different and so should be washed at different intervals. While every week or two will generally suffice for sheets, towels are best washed every few days.

Anyway, who doesn’t love the feeling of a fresh set of sheets or the smell of a newly laundered towel?

Why you should wash towels more often

When you dry yourself, you deposit thousands of skin cells and millions of microbes onto the towel. And because you use your towel to dry yourself after a shower or bath, your towel is regularly damp.

You also deposit a hefty amount of dead skin, microbes, sweat and oils onto your sheets every night. But unless you’re a prolific night sweater, your bedding doesn’t get wet after a night’s sleep.

Towels are also made of a thicker material than sheets and therefore tend to stay damp for longer.

So what is it about the dampness that causes a problem? Wet towels are a breeding ground for bacteria and moulds. Moulds especially love damp environments. Although mould won’t necessarily be visible (you would need significant growth to be able to see it) this can lead to an unpleasant smell.

As well as odours, exposure to these microbes in your towels and sheets can cause asthma, allergic skin irritations, or other skin infections.

So what’s the ideal frequency?

For bedding, it really depends on factors such as whether you have a bath or shower just before going to bed, or if you fall into bed after a long, sweaty day and have your shower in the morning. You will need to wash your sheets more regularly in the latter case. As a rule of thumb, once a week or every two weeks should be fine.

Towels should ideally be washed more regularly – perhaps every few days – while your facecloth should be cleaned after every use. Because it gets completely wet, it will be wet for a longer time, and retain more skin cells and microbes.

Wash your towels at a high temperature (for example, 65°C) as that will kill many microbes. If you are conscious of saving energy, you can use a lower temperature and add a cup of vinegar to the wash. The vinegar will kill microbes and prevent bad smells from developing.

Clean your washing machine regularly and dry the fold in the rubber after every wash, as this is another place microbes like to grow.

Smelly towels

What if you regularly wash your towels, but they still smell bad? One of the reasons for this pong could be that you’ve left them in the washing machine too long after the wash. Especially if it was a warm wash cycle, the time they’re warm and damp will allow microbes to happily grow. Under lab conditions the number of these bacteria can double every 30 minutes.

It’s important to hang your towel out to dry after use and not to leave towels in the washing machine after the cycle has finished. If possible, hang your towels and bedding out in the sun. That will dry them quickly and thoroughly and will foster that lovely fresh, clean cotton smell. Using a dryer is a good alternative if the weather is bad, but outdoors in the sun is always better if possible.

Also, even if your towel is going to be washed, don’t throw a wet towel into the laundry basket, as the damp, dirty towel will be an ideal place for microbes to breed. By the time you get to doing your washing, the towel and the other laundry around it may have acquired a bad smell. And it can be difficult to get your towels smelling fresh again.

What about ‘self-cleaning’ sheets and towels?

Some companies sell “quick-dry” towels or “self-cleaning” towels and bedding. Quick-dry towels are made from synthetic materials that are weaved in a way to allow them to dry quickly. This would help prevent the growth of microbes and the bad smells that develop when towels are damp for long periods of time.

But the notion of self-cleaning products is more complicated. Most of these products contain nanosilver or copper, antibacterial metals that kill micro-organisms. The antibacterial compounds will stop the growth of bacteria and can be useful to limit smells and reduce the frequency with which you need to clean your sheets and towels.

However, they’re not going to remove dirt like oils, skin flakes and sweat. So as much as I would love the idea of sheets and towels that clean themselves, that’s not exactly what happens.

Also, excessive use of antimicrobials such as nanosilver can lead to microbes becoming resistant to them.

Rietie Venter, Associate professor, Clinical and Health Sciences, University of South Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.