The Facts and My Real Experience taking Ryeqo for Endometriosis and Chronic Pelvic Pain
When you live with endometriosis and a combination of Chronic Pelvic Pain, you reach a point where you’ll consider almost anything for relief.
After surgeries, procedures, daily pain medication, heat packs, flare ups that steal hours, days and weeks from me, the constant mental load of managing symptoms I started Ryeqo. Not because I was desperate. But because I needed another option.
The usual contraceptive tablets weren’t working for me and my doctor says; after 12 weeks if you don’t feel a difference change it up and thats what I needed to feel a difference.
This is both the science behind Ryeqo and my honest experience taking it.
What Is Ryeqo?
This is a once daily tablet made up of:
Relugolix – suppresses ovarian hormone production.
Estradiol – “add-back” estrogen
Norethisterone acetate progestin to protect the uterus.
It also stops you going into menopause prematurely because Ryeqo puts your ovaries to sleep reducing painful cycle changes and periods (partially its different for everyone) but thats the kicker no menopause.
It works by blocking GnRH receptors in the brain, essentially lowering estrogen levels, because estrogen fuels endometriosis lesions and inflammation. It creates a medically controlled, low-estrogen state (similar to a temporary menopause without the menopause), but with added hormones to reduce harsh side effects.
In clinical trials, around 70–75% of women had meaningful reductions in menstrual and non-menstrual pelvic pain over 24 weeks. Some maintained relief for up to two years.
It’s approved in Australia for moderate to severe endometriosis symptoms and now covered under PBS $25 australian dollars for a 28 day bottle of Ryeqo.
But numbers don’t tell the full story.
Why I Chose to Try It? I live with Chronic pelvic pain, Nerve pain, Endometriosis of the Bladder and Bowel Chronic inflammation and Daily medication management.
I am not new to hormone treatments.
I understand suppression.
I understand risk versus benefit.
For me, Ryeqo represented:
A chance to reduce flares
A chance to reduce inflammation
A chance to maybe reduce my reliance on pain medication
A chance to stabilise the hormonal rollercoaster.
When you live in survival mode with pain, even a small improvement matters.
What the First Weeks Felt Like (My Experience)
Here is the part people don’t talk about enough.
The first couple of weeks were not gentle. I experienced significant nausea (like morning sickness I felt it in my whole body) for those who experienced this in pregnancy – if not whole body nausea/sickness
Dizziness and light-headedness
Increased sweating
Mild Headaches
Dramatic Mood shifts (not constant but I could feel it happening)
An inflammatory pelvic response it increased inflammatory pain and pelvic inflammation for a few weeks.
There were moments I questioned whether it was making things worse (before it got better) and honestly a week in I wanted to stop, but I didn’t I endured and Im glad I did.
The dizziness especially caught me off guard. It randomly came on at a point during the day or morning/night it didn’t matter if I was sitting standing or walking I felt it and it was surprising/unexpected.
The nausea made eating harder and when you already manage pain flares by eating light, safe foods, that adds another layer so try stick to light foods like fruit, veggie’s, crackers and nothing to high in saturated fats.
Emotionally? Hormonal shifts are not subtle. Even when you know they’re coming.
There was nothing subtle about my mood changes from these tablets. (The first week was the toughest)
What I’ve Noticed So Far
There have also been subtle shifts:
Some reduction in the sharp cyclical spikes, slight easing in certain, inflammatory episodes, cravings changing (lighter foods feel better)
and my body feeling hormonally “different”
It hasn’t been a miracle pill.
But it also hasn’t been a failure.
It feels like my body is adjusting.
And that’s the honest middle ground no one prepares you for the grey area between hope and discomfort.
The Clinical Reality
Common side effects listed in trials include:
Headaches, Hot flushes, Mood changes, Irregular bleeding and Reduced bone density over long-term use.
You can up your calcium intake during this time for bone density.
Because it suppresses ovarian hormones, bone monitoring is important for longer treatment durations.
It’s not suitable for everyone, especially those with clotting disorders, certain cancers, liver disease, or during pregnancy.
It cannot be combined with other hormonal contraceptives.
It is not a cure.
It is a management tool.
What I Think Women Should Know Before Starting
The first weeks can feel destabilising. Hormonal side effects are real — not “in your head.” Your nervous system might feel sensitive while adjusting. Pain patterns can temporarily fluctuate, It requires monitoring and honest conversations with your doctor.
But also:
If it works for you, it can reduce pain significantly.
And even a 30% improvement in chronic pain can change daily life.
The Bigger Picture
Living with endometriosis means constantly balancing:
Pain, Medication, Hormones, Mental health, Family life, Work and Identity.
Starting Ryeqo wasn’t just starting a tablet. It was another decision in a long journey of managing a body that doesn’t behave predictably. That’s something clinical trials can’t measure.
Managing Side Effects on Ryeqo What Helped Me?
Starting Ryeqo isn’t just about swallowing a tablet. It’s about supporting your body while it adjusts to hormonal suppression.
Here’s what I’ve personally found helpful so far:
1. Dizziness & Light-Headedness this one caught me off guard.
What helped:
Standing up slowly (even pausing before fully upright)
Increasing fluids and electrolytes
Eating small, regular meals instead of large ones
Sitting down immediately if I felt the wave coming
Hormonal shifts can affect blood pressure and nervous system regulation. If dizziness is persistent or severe, that’s something to discuss with your doctor, don’t push through it.
2. Nausea
The nausea felt very “hormonal” — similar to early pregnancy or PMS nausea.
What helped:
Light, easy-to-digest foods (fruit, yogurt, crackers)
Avoiding heavy or greasy meals
Eating before the tablet if needed
Ginger tea or peppermint tea
On flare days, I lean into what my body tolerates instead of what I “should” be eating.
3. Increased Sweating / Hot Flushes
Even with add-back hormones, suppression can cause temperature regulation changes.
What helped:
Breathable clothing
Keeping a fan nearby at night
Hydration
Not panicking when it happens (stress makes it worse)
Usually these are strongest early on and may settle.
4. Mood Changes
This one deserves honesty. The irritation Ive felt has been something I cant disregard.
Hormone shifts affect:
Serotonin
Stress tolerance
Emotional regulation – as Im only two weeks in I will have to update this within the 24 week mark where they say is when ryeqo is in full effect.
What helped:
Tracking mood alongside physical symptoms
Telling my partner what might be happening so he understands
Giving myself permission to rest
Reducing unnecessary stressors during adjustment
If mood drops significantly or you feel unsafe, seek medical support immediately. Hormonal medications can impact mental health more than people expect.
5. Pain Fluctuations During Adjustment
Something not discussed enough, Pain can temporarily spike or change pattern when hormones shift.
I noticed:
Random nerve zaps
Increased inflammation
More irritation to my pain in general.
What helped:
Heat packs
Gentle movement instead of full rest
Keeping pain medication consistent as prescribed increased slightly for a short period
Reminding myself this might be transitional
If pain escalates significantly or becomes unmanageable, that’s a review point, not a personal failure.
Some medication that may help in those first few weeks
Anti Nausea tablets/wafers
ProCalm tablets – for dizziness and lightheadedness
Nurophen and Panadol
Your usual Pain Management Medication
Practical Tips Before Starting
If I could prepare someone ahead of time, I’d say:
Start when you don’t have major life events scheduled
Have anti-nausea support ready if you’re prone to it
Plan lighter days for the first couple of weeks
Track symptoms daily
Stay in close contact with your GP or specialist
Adjustment is real. Preparation makes it less scary – I wasn’t prepared!
The Most Important Part
Side effects don’t mean you’re weak.
They don’t mean you’re dramatic.
They don’t mean the medication is automatically wrong for you.
But they do mean your body deserves monitoring.
The goal is improved quality of life not just tolerating a new kind of discomfort.
If at any point the side effects outweigh the benefits, that’s data. And you’re allowed to make decisions based on that.
My Personal Perspective
I don’t regret taking it so far, but with the side effects Ive wanted to quit more than twice, but Im choosing to see it through for at least three months.
I am cautious.
I am observant.
I am advocating for myself.
I am tracking changes.
I am listening to my body.
If you’re considering Ryeqo, ask yourself:
What is my baseline pain right now?What am I hoping this changes?
Am I prepared for an adjustment period?
Do I have support if side effects hit?
This medication might be a turning point for some.
For others, it may not be the right fit.
And neither outcome is failure.
A simple reality we all live with with endometriosis
Endometriosis forces us to become researchers, advocates, and decision-makers in our own healthcare.
Ryeqo is another option in a limited toolbox. Covered under PBS now and well priced for a more current way to eventually reduce pain and endo growth to a degree.
Not a cure.
Not magic.
Not harmless.
Not hopeless.
Its an option and sometimes, an option is enough to try.
A Gentle Word If You’re Feeling Unsure
Starting something new can be intimidating I always second guess and wonder about side effects and changes but I have chosen to take a leap of faith for the next three months for myself.
Hormone suppression sounds big.
Side effects sound scary.
And when you already live in a body that feels unpredictable, adding something new can feel like a risk.
I want to be honest about something important, This wasn’t a random decision. Ryeqo was recommended to me by both my senior gynaecologist and my GP doctor, who are highly experienced in treating endometriosis and who work with complex pelvic pain patients regularly. They have seen good outcomes in many women.
That mattered to me greatly as my faith has wained with lacking results from the contraception pill track.
It wasn’t prescribed lightly.
It wasn’t a “try this and see” dismissal.
It was a considered option within a broader treatment plan.
And that context matters.
If you’re considering Ryeqo, I hope you have a clinician who listens, supports concerns and explains risks/positive’s properly, and monitors you closely. When a medication is recommended by professionals who understand endometriosis deeply and who have seen it help others that carries weight.
You are not weak for needing medical support.
You are not failing because your body requires intervention.
You are managing a chronic inflammatory disease.
Trying something new doesn’t mean you’re failing your winning!
It means you’re advocating for a better quality of life.
Some women will thrive on Ryeqo.
Some won’t tolerate it.
Some will sit somewhere in the middle, like I currently am observing, adjusting, reassessing.
And that’s okay.
The goal is not perfection.
The goal is improvement.
Even small reductions in pain can mean:
More present parenting/friendships
A more stable mood
Fewer days lost to flares
A little more energy to be yourself again
If you’re scared but hopeful, that’s normal.
Take the information.
Ask the questions.
Trust your instincts.
And make the decision that aligns with your body and your circumstances.
You deserve options and hopefully I have helped you in a way I needed when nothing else was effective, what do we have to lose.
Cassie x
Welcome Beautiful 