What is Ryeqo, the recently approved medicine for endometriosis?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
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.
Shutterstock
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.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
How Regularity Of Sleep Can Be Even More Important Than Duration
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
A recent, large (n=72,269) 8-year prospective* observational study of adults aged 40-79 has found an association between irregular sleep and major cardiovascular events.
*this means they started the study at a given point, and measured what happened for the next eight years—as opposed to a retrospective study, which would look at what had happened during the previous 8 years.
As to what qualifies as major cardiovascular events, they counted:
- Heart attack
- Cardiac arrest
- Stroke
- Cardiovascular death (any)
Irregular sleep, meanwhile, was defined per a bell curve of participants. Based on a sleep regularity index (SRI) score, those with a score of 87 or more were on the “regular” side of the curve, and those with a score of 72 or lower were on the “irregular” side of the curve.
What they found is that irregular sleep is associated with major cardiovascular events, regardless of the actual amount of sleep that people got. So in other words, you could be sleeping 9 hours per day, but if it’s a different 9 hours each day, your cardiovascular risk will still be higher.
How much higher?
- For those in the middle of the curve (so, moderate irregularity), it was 8% higher than those on the “regular” side.
- For those on the “irregular” side of the curve, it was 26% higher than those on the “regular” side.
All of the above is after taking into account confounding variables such as age, physical activity levels, discretionary screen time, fruit, vegetable, and coffee intake, alcohol consumption, smoking, mental health issues, medication use, and shift work. Which is quite something, given that shift work is a very common reason for irregular sleep schedules in a lot of people.
Limitations
While, as noted above, they did their best to account for a lot of things, this was an observational study, not an interventional study or a randomized controlled trial, and as such, it cannot truly establish cause and effect.
For example, an observational study in the 90s found that the sport most strongly associated with longevity was polo. For any unfamiliar, it’s a game played on horseback with mallets and balls. Why was this game so much better than, say, swimming? And the answer is most likely that polo is played almost entirely by very rich people. It wasn’t the sport that enhanced longevity—it was the wealth.
So similarly here, it could be for example that people who are predisposed to heart conditions, are prone to having irregular schedules. We won’t know for sure until we have interventional studies (and we probably can’t get RCTs for this, for practical reasons).
Still, it seems likely that the association is indeed causal, in which case, having a regular sleep schedule if at all possible seems like a very good way to look after one’s health.
You can read more about the study here:
Irregular sleep may elevate risk of major cardiovascular events
Practical take-away
This study strongly suggests that sleep regularity is even more important than sleep duration.
This means that there is extra reason to not sleep in past one’s normal getting-up time, even if one had a less restful night.
That’s the end of sleep that’s the most important in practical terms, too, because we can control our getting-up time, whereas we can’t really control our going-to-sleep time, because it’s perfectly possible to just lie there awake.
So, controlling the getting-up time is really the key to the whole thing. See also:
Calculate (And Enjoy) The Perfect Night’s Sleep
And for scope, you might enjoy reading:
Morning Larks vs Night Owls: How Much Can We Control Our Sleep Schedule?
Enjoy!
Share This Post
-
Anti-Inflammatory Diet 101 (What to Eat to Fight Inflammation)
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Chronic inflammation is a cause and/or exacerbating factor in very many diseases. Arthritis, diabetes, and heart disease are probably top of the list, but there are lots more where they came from. And, it’s good to avoid those things. So, how to eat to avoid inflammation?
Let food be thy medicine
The key things to keep in mind, the “guiding principles” are to prioritize whole, minimally-processed foods, and enjoy foods with plenty of antioxidants. Getting a healthy balance of omega fatty acids is also important, which for most people means getting more omega-3 and less omega-6.
Shopping list (foods to prioritize) includes:
- fruits and vegetables in a variety of colors (e.g. berries, leafy greens, beats)
- whole grains, going for the most fiber-rich options (e.g. quinoa, brown rice, oats)
- healthy fats (e.g. avocados, nuts, seeds)
- fatty fish (e.g. salmon, mackerel, sardines) ← don’t worry about this if you’re vegetarian/vegan though, as the previous category can already cover it
- herbs and spices (e.g. turmeric, garlic, ginger)
Noping list (foods to avoid) includes:
- refined carbohydrates
- highly processed and/or fried foods
- red meats and/or processed meats (yes, that does mean that organic grass-fed farmers’ pinky-promise-certified holistically-raised beef is also off the menu)
- dairy products, especially if unfermented
For more information on each of these, plus advice on transitioning away from an inflammatory diet, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
How to Prevent (or Reduce) Inflammation
Take care!
Share This Post
-
The Imperfect Nutritionist – by Jennifer Medhurst
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
The idea of the “imperfect nutritionist” is to note that we’re all different with slightly different needs and sometimes very different preferences (or circumstances!) and having a truly perfect diet is probably a fool’s errand. Should we just give up, then? Not at all:
What we can do, Medhust argues, is find what’s best for us, realistically.
It’s better to have an 80% perfect diet 80% of the time, than to have a totally perfect diet for four and a half meals before running out of steam (and ingredients).
As for the “seven principles” mentioned in the title… we’re not going to keep those a mystery; they are:
- Focusing on wholefood
- Being diverse
- Knowing your fats
- Including fermented, prebiotic and probiotic foods
- Reducing refined carbohydrates
- Being aware of liquids
- Eating mindfully
The first part of the book is a treatise on how to implement those principles in your diet generally; the second part of the book is a recipe collection—70 recipes, with “these ingredients will almost certainly be available at your local supermarket” as a baseline. No instances of “the secret to being a good chef is knowing how to source fresh ingredients; ask your local greengrocer where to find spring-harvested perambulatory truffle-cones” here!
Basically, it focusses on adding healthy foods per your personal preferences and circumstances, and building these up into a repertoire of meals that will keep you and your family happy and healthy.
Pick Up Your Copy Of The Imperfect Nutritionist From Amazon Today!
Share This Post
-
Before You Eat Breakfast: 3 Surprising Facts About Intermittent Fasting
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Dr. William Li is well-known for his advocacy of “eating to beat disease”, and/but today he has advice for us about not eating to beat disease. In moderation, of course, thus: intermittent fasting.
The easy way
Dr. Li explains the benefits of intermittent fasting; how it improves the metabolism and gives the body a chance to do much-needed maintainance, including burning off any excess fat we had hanging around.
However, rather than calling for us to do anything unduly Spartan, he points out that it’s already very natural for us to fast while sleeping, so we only need to add a couple of hours before and after sleeping (assuming an 8 hour sleep), to make it to a 12-hour fast for close to zero effort and probably no discomfort.
And yes, he argues that a 12-hour fast is beneficial, and even if 16 hours would be better, we do not need to beat ourselves up about getting to 16; what is more important is sustainability of the practice.
Dr. Li advocates for flexibility in fasting, and that it should be done by what manner is easiest, rather than trying to stick to something religiously (of course, if you do fast for religious reasons, that is another matter, and/but beyond the scope of this today).
For more information on each of these, as well as examples and tips, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Intermittent Fasting: What’s the truth?
- 16/8 Intermittent Fasting For Beginners
- Meal Timings & Health: How Important Is Breakfast?
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
The Longevity Diet – by Dr. Valter Longo
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Another book with “The New Science” in its subtitle, so, is this one a new science?
Yes and no; some findings are new, many are not, what really sets this book apart from many of its genre though is that rather than focusing on fighting aging, it focuses on retaining youth. While this may seem like one and the same thing, there is a substantive difference beyond the ideological, which is: while anti-aging research focuses on what causes people to suffer age-related decline and fights each of those things, Dr. Longo’s research focuses on what is predominant in youthful bodies, cells, DNA, and looks to have more of that. Looking in a slightly different place means finding slightly different things, and knowledge is power indeed.
Dr. Longo bases his research and focus on his “5 pillars of longevity”. We’ll not keep them a mystery; they are:
- Juventology research
- Epidemiology
- Clinical studies
- Centenarian studies
- Study of complex systems
The first there (juventology research) may sound like needless jargon, but it is the counterpoint of the field of gerontology, and is otherwise something that didn’t have an established name.
You may wonder why “clinical studies” gets a separate item when the others already include studies; this is because many studies when it comes to aging and related topics are population-based studies, cohort studies, observational studies, or (as is often the case) multiple of the above at once.
Of course, all this discussion of academia is not itself practical information for the reader (unless we happen to work in the field), but it is interesting and does give confidence in the conclusions upon which the practical parts of the book are based.
And what are they? As the title suggests, it’s about diet, and specifically, it’s about Dr. Longo’s “fast-mimicking diet”, which boasts the benefits of intermittent fasting without intermittent fasting. This hinges, of course, on avoiding metabolic overload, which can be achieved with a fairly simple diet governed by the principles outlined in this book, based on the research referenced.
In the category of subjective criticism, there is quite a bit of fluff, much of it self-indulgently autobiographical and very complimentary, but its presence does not take anything away from the excellent content contained in the book.
Bottom line: if you’d like a fresh perspective on regaining/retaining youthfulness, then this is a great book to read.
Click here to check out The Longevity Diet, and stay younger!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Eat Move Sleep – by Tom Rath
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
The subtitle of this book, “how small choices lead to big changes“, is very much the idea that a lot of what we do here at 10almonds is about.
And the title itself, “Eat Move Sleep”? Well, that’s 3/5 of The Usual Five Things™ that we promote here (the other two being: reduce or eliminate alcohol, and don’t smoke). So, naturally this book got our attention.
One of the key ideas that Rath presents is that every action we take leads to a net gain or loss in health. The question then is: what are the biggest point-swingers? In other words, what are the places in our life where the smallest changes can make the biggest difference?
Rath looks at what parts of diet make the biggest difference to our health, and the findings there alone probably make reading the book worthwhile.
When it comes to movement, he actually flips this! For Rath, it’s less about how much exercise you get, and more about minimizing how long we spend not moving… And especially, minimizing how long we spend sitting. So, lots of little tweaks for that.
In the category of sleep: a key idea is that quality is as important as quantity, and there’s an aspect of bringing together as a synergistic routine. To finish off a productive day with good rest, and power up ready for the next morning.
In short: tying these items together—and focusing on the smallest choices that lead to the biggest changes—makes for quite a manifesto that we could describe as “Atomic Habits, for health specifically”.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
