Consider this a PSA: Your periods shouldn’t involve severe pain or very heavy bleeding or be a reason to cancel plans. What may seem like just a bad period shouldn’t be dismissed, because it could be a serious medical condition that needs attention. If you notice changes in your period, or if something doesn’t feel right, it’s important for you to talk to your doctor about your symptoms as they could be a sign of endometriosis or uterine fibroids.
In the U.S., endometriosis affects one in ten women (or 10 percent) of reproductive age. It occurs when tissue—similar to the tissue that forms the uterine lining (aka the endometrium)—is found growing outside of the uterine cavity. Uterine fibroids, meanwhile, are noncancerous growths that develop in or on the walls of your uterus; about seven out of ten women (70 percent) will be diagnosed with uterine fibroids by the age of 50. (We’ll talk more about uterine fibroids later.)
Endometriosis can begin with a woman’s first period and last for decades, usually until menopause. As many as 80 percent of women living with endometriosis experience symptoms, although severe pain and bleeding aren’t the only burdensome symptoms. For some women, abdominal pain, fatigue and painful intercourse or bowel movements can also be telltale indicators of the condition.
Unfortunately, these symptoms or, more precisely, the variability of symptoms, can make it a challenge to diagnose. “Patients with endometriosis may present with one, some or even none of these symptoms,” says Rosanne M. Kho, MD, an obstetrics and gynecology professor in Phoenix. “This is why it can take up to 10 years for some women to receive an accurate diagnosis.”
And that’s why endometriosis should be on your radar. Here, Dr. Kho shares what she thinks all women should know about the condition.
Understanding your uterine health.
When it comes to understanding if you’re at risk for endometriosis, looking to your mother, grandmother, and other women in your family could give you a clue. “There may be a genetic component to endometriosis,” says Dr. Kho. While science is still trying to pinpoint why it occurs, data show that there is a 50 percent chance endometriosis can be inherited.
“I do want to note that not all women who have the condition have a family predisposition,” stresses Dr. Kho. “There are other factors that could lead to an endometriosis diagnosis. Even something like retrograde menstruation, when your period flows backward, can increase your chances of the disease.”
Each woman’s experience with endometriosis is different, which is why it is imperative to have an unfiltered conversation with your doctor if you feel that something is off.
Endometriosis can affect almost every aspect of your life.
The discomfort of endometriosis symptoms can take a huge toll on women. “The condition can affect the quality of your life,” says Dr. Kho. “It can impact your intimate relationships, for example. Endometriosis can also affect your ability to function well at work and at home. And, it can lead to infertility and other complications.”
“Many people start experiencing symptoms of endometriosis during adolescence and young adulthood; however, there is typically a years-long delay between the onset of symptoms to diagnosis,” Dr. Kho reiterates. One of the reasons for this is that the disease can present differently in each woman and the symptoms may be similar to other conditions, making it difficult to diagnose. Another reason is that patients might accept their symptoms as “normal” and may not receive a correct diagnosis. “These patients usually end up seeing so many different providers until they find someone who can give them a path forward,” says Dr. Kho. “It’s so important to be able to find a doctor who you feel comfortable speaking with, understands the condition and is able to diagnose you quickly.”
Know this: If you have endometriosis, the pain you feel is real and you have a right to relief. And since it can impact menstrual pain, pain between periods, and pain during sex, it is important for you and your doctor to create a treatment plan that works for you. Women can and should advocate for the care they deserve and to find a treatment approach that works best for them.
Endometriosis can be diagnosed and addressed more easily than you think.
Many women are nervous to share their symptoms, but if you’re living with painful periods, you’ve noticed changes, or you feel like something is off, it’s important to listen to your body and speak up. While surgery was, historically, the only way to diagnose the condition, imaging technology is now making it a lot easier. “A suspicion of endometriosis does not mean that we need to do surgery,” says Dr. Kho. “We’re moving further and further away from that.” Tests such as an MRI and/or ultrasound targeted to look for deep and ovarian endometriosis can often be helpful, along with the patient’s symptoms. “Imaging may allow us to diagnose the condition before or without having to do surgery.”
Treatment options can range from medication to surgery and are determined based on a number of factors including the severity of the condition, age, stage of family planning, and other health factors. It’s important to talk to your doctor to learn more about potential treatment options for your moderate to severe pain from endometriosis, including MYFEMBREE® (relugolix, estradiol, and norethindrone acetate), a medication jointly commercialized by Sumitomo Pharma America, Inc. and Pfizer, Inc.
MYFEMBREE is a once-daily pill approved by the U.S. Food and Drug Administration (FDA) for premenopausal women over 18 years of age to manage moderate to severe pain associated with endometriosis. MYFEMBREE is a treatment proven to relieve three types of endometriosis pain: during your period, in between periods, and during sex (based on those women who were engaging in sex at the start of and during clinical trials).
MYFEMBREE is also indicated to control heavy menstrual bleeding associated with uterine fibroids in premenopausal women, a common condition in premenopausal women that can share some of the symptoms of endometriosis.
MYFEMBREE should not be taken for more than 24 months, due to the risk of bone loss that may not be reversible.
IMPORTANT SAFETY INFORMATION
Boxed Warning. Cardiovascular conditions: Myfembree may increase your chances of heart attack, stroke, or blood clots, especially if you are >35 years old and smoke or have uncontrolled high blood pressure. Stop taking Myfembree and call your healthcare provider (HCP) or go to the nearest emergency room right away if you have: leg pain or swelling that won’t go away; sudden shortness of breath; double vision, bulging of the eyes, sudden partial or complete blindness; pain or pressure in your chest, arm, or jaw; sudden, severe headache unlike your usual headaches; weakness or numbness in an arm or leg, or trouble speaking.
“Approximately 70 percent of women can have fibroids by the time they reach the age of 50,” says Dr. Kho. Research shows that Black women are three times more likely to experience uterine fibroids than white women, and genetics may play a role too.
“Just because fibroids are present doesn’t mean that a patient will have symptoms,” Dr. Kho points out. That said, research also shows that fibroids can cause heavy menstrual bleeding, pain, and anemia. “Fibroids do need to be addressed if a patient has symptoms that impacts them,” Dr. Kho emphasizes.
The bottom line: It’s important that women listen to their bodies and speak up if they have symptoms or notice changes. You don’t have to live with painful periods. Talk to your doctor today and know that there are treatments available that can help.
IMPORTANT SAFETY INFORMATION (continued)
Do not take Myfembree if you:
- have or have had blood clots in your legs, lungs, or eyes; a stroke or heart attack; a problem that makes your blood clot more than normal; blood circulation disorders; certain heart valve or rhythm problems that can cause blood clots to form in the heart; high blood pressure not well controlled by medicine; diabetes with kidney, eye, nerve, or blood vessel damage; certain kinds of severe migraine headaches with aura, numbness, weakness or changes in vision or migraine headaches if you are >35 years old; breast cancer or any cancer that is sensitive to female hormones; osteoporosis; undiagnosed vaginal bleeding; liver problems;
- smoke and are >35 years old;
- have had a serious allergic reaction (e.g., swelling of your face, lips, mouth or tongue, trouble breathing, skin rashes, redness) or swelling or an allergic reaction to relugolix, estradiol, norethindrone or any of the ingredients in Myfembree.
Bone loss (decreased bone mineral density [BMD]). While taking Myfembree, your estrogen levels may be low, which can lead to BMD loss. If this happens, your BMD may improve after you stop Myfembree, but complete recovery may not occur. It is unknown if these BMD changes could increase your risk for broken bones as you age. For this reason, you should not take Myfembree for more than 24 months. Your HCP may order an X-ray test called a DXA scan to check your BMD when you start Myfembree and periodically after you start if you have uterine fibroids or annually if you have pain associated with endometriosis.
Suicidal thoughts and behavior and worsening of mood. Call your HCP or get emergency medical help right away if you have any of these symptoms, especially if they are new, worse, or bother you: thoughts about suicide or dying, attempts to commit suicide, new or worse depression or anxiety, other unusual changes in behavior or mood. Pay attention to any changes, especially sudden changes in your mood, behaviors, thoughts, or feelings.
Abnormal liver tests. Call your HCP right away if you have any of these signs and symptoms of liver problems: jaundice, dark, amber-colored urine, feeling tired, nausea and vomiting, generalized swelling, right upper stomach area pain, bruising easily.
High blood pressure. See your HCP to check your blood pressure regularly.
Effects on pregnancy. Do not take Myfembree if you are trying to become or are pregnant. It may increase the risk of early pregnancy loss. If you think you are pregnant, stop taking Myfembree right away and call your HCP. Myfembree can cause decreased or no menstrual bleeding, making it hard to know if you are pregnant. Watch for other signs of pregnancy like breast tenderness, weight gain, and nausea. Myfembree does not prevent pregnancy. You will need to use effective non-hormonal methods of birth control (e.g., condoms, spermicide) during and for 1 week after stopping Myfembree. Do not take hormonal birth control such as birth control pills, because they may increase side effects and Myfembree may not work as well.
Uterine fibroid prolapse or expulsion. Fibroids can come out completely or partially through the vagina. Call your HCP right away if you have increased bleeding from the vagina, which can be serious, or cramping.
Severe allergic reactions. Myfembree may cause swelling of your face, lips, mouth or tongue, trouble breathing, skin rashes, and redness.
Most common side effects in heavy menstrual bleeding with uterine fibroids are hot flushes, increased sweating, night sweats, abnormal vaginal bleeding, hair loss or thinning, and decreased interest in sex.
Most common side effects in moderate to severe pain with endometriosis are headache, hot flushes/sweating/night sweats, mood changes including worsening depression, abnormal vaginal bleeding, nausea, toothache, back pain, decreased interest in sex, joint pain, tiredness, and dizziness.
These are not all the possible side effects of Myfembree. Call your doctor for medical advice about side effects.
Tell your HCP about all your prescription and over-the-counter medicines, vitamins, and herbal supplements. If you take oral P-gp inhibitors, take Myfembree first and wait at least 6 hours before taking the P-gp inhibitor. Ask your HCP if you are not sure if you are taking this type of medicine.
Tell your HCP if you are breastfeeding. Myfembree may pass into your breast milk.
USE
Myfembree is used in premenopausal women ≥18 years of age to:
- control heavy menstrual bleeding due to uterine fibroids or
- manage moderate to severe pain associated with endometriosis
It should not be taken for more than 24 months.
Please see full Prescribing Information, including BOXED WARNING and Patient Information
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Sumitomo Pharma America, Inc. is a U.S. subsidiary of Sumitomo Pharma Co., Ltd.
MYFEMBREE is a trademark of Sumitomo Pharma Switzerland GmbH.
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PP-US-REL-CT-2400026 03/2024
