A new approach in the Italian landscape of chronic pelvic pain and endometriosis

Endometriosis entails a huge burden: it is estimated that affects 10% of women in their reproductive age. Symptoms may be severe (chronic pelvic pain, dysmenor-rhea, dyspareunia, dysuria, dyschezia and fatigue) affecting women’s quality of life from a personal, familiar, social and professional point of view. Endometriosis may also affect fertility. The economic burden of endometriosis is relevant. Despite the recent improvements patients ‘journey before diagnosis is still long and difficult. Different options for the treatment have been proposed: hormonal therapies that suppress ovulation and menstruation, surgical treatment or a combination of both. The most recent tools for the medical management of endometriosis are the oral GnRH antagonists with add-back therapy (ABT). Relugolix Combination Therapy (CT) (40 mg Relugolix + 1 mg estradiol as hemihydrate + 0.5 mg norethi-sterone acetate), one tablet daily, is licensed in adult women of reproductive age for symptomatic treatment of endometriosis in women with a history of previous medical or surgical treatment for their endometriosis as well as for treatment of moderate to severe symptoms of uterine fibroids. The triple combination has the aim of combining the activity on endometriosis’s symptoms with the maintenan-ce of oestradiol and progesterone levels in an optimal therapeutic range, in order to minimize the adverse effects. Nowadays oral relugolix CT may help to solve an unmet need for a condition with such a severe impact on all aspects of women’s lives with an effective, well-tole-rated, and convenient medical treatment for endometriosis, maintaining a long-term care on women’s health, preserving their bone mass.