Short-term Use of GnRH Antagonist for Severe Pain in Endometriosis

Background: Endometriosis, a chronic illness reliant on estrogen, affects 6-10% of women of reproductive age, leading to symptoms including pelvic pain and infertility.This study explores the short-term effectiveness of the GnRH antagonist Elagolix in managing severe pain in endometriosis patients, aiming to balance symptom relief with treatment cost by switching to low-cost progesterone therapy after 1 month.Methodology: Fifty-four women with endometriosis who had excruciating pain and infertility participated in a prospective observational study at Infertility Care and Research Centre (ICRC), Dhaka.Participants received 200 mg of Elagolix twice a day for 1 month.Dienogest was then administered for ongoing care.The numerical rating scale (NRS) was used to quantify pain at baseline, 1 month, and 3 months.Ultrasonography was performed to track the size of the endometrioma.Results: Following 1 month of treatment, the average pain scores diminished from 7.05 at baseline to 0.48, then decreasing to 0.11 at 3 months, signifying a substantial reduction in pain.The endometrioma size stabilized, according to the ultrasound evaluation, which improved patients' quality of life.Conclusion: The short-term administration of Elagolix, in conjunction with dienogest maintenance, effectively alleviated pain and improved quality of life, presenting a cost-effective approach to endometriosis treatment.According to these results, Elagolix can be used to relieve pain right away before beginning maintenance medication, especially for patients getting ready for reproductive procedures.