Elagolix Beyond the Ovary: A Novel Approach to Endometriosis Management

Jahan Ismat, Rumana Ratu, akter Tasnuva
2026 · doi:10.5281/zenodo.18797204 · W7131889071
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This prospective, hospital-based observational study evaluated elagolix 150 mg once daily for six months in 80 women aged 20–45 years with clinically, ultrasonographically, or laparoscopically confirmed endometriosis, assessing pain (NRS 0–10), ovarian cyst volume, and regression of extra-pelvic lesions at baseline, 3 months, and 6 months. Mean pain scores decreased significantly from 8.1 ± 1.0 to 2.9 ± 1.3 (p < 0.001), with pain reduction observed across ovarian, peritoneal, deep infiltrating (DIE), umbilical, and scar endometriosis subtypes. Ovarian cyst volume decreased modestly (mean 18%), while umbilical and scar lesions showed regression of swelling and cyclic bleeding, and adverse effects were described as mild and self-limiting. This paper is centrally about endometriosis — it specifically evaluates elagolix’s symptom control across ovarian and extra-ovarian (including umbilical and surgical scar) endometriosis.

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Abstract

Abstract Background: Endometriosis affects approximately 10% of reproductive-age women and manifests as chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility [1]. While ovarian endometrioma is frequently recognized, extra-ovarian forms such as peritoneal, deep infiltrating (DIE), and extra-pelvic endometriosis (e.g., umbilical or surgical scar lesions) represent clinically significant but often underdiagnosed variants [2,3].Objective: To evaluate the clinical effectiveness of elagolix in symptom control of both ovarian and extra-ovarian endometriosis.Methods: This prospective, hospital-based observational study included 80 women (20–45 years) with clinically, ultrasonographically, or laparoscopically confirmed endometriosis. Participants received elagolix 150 mg once daily for six months. Pain scores (NRS 0–10), ovarian cyst volume, and regression of extra-pelvic lesions were evaluated at baseline, 3 months, and 6 months.Results: Mean pain scores decreased from 8.1 ± 1.0 to 2.9 ± 1.3 (p < 0.001). Pain reduction occurred across all subtypes—ovarian (63.9%), peritoneal (60%), DIE (62%), umbilical (61%), and scar endometriosis (59%). Ovarian cyst volume decreased modestly (mean 18%). Umbilical and scar lesions showed regression of swelling and cyclic bleeding. Adverse effects were mild and self-limiting.Conclusion: Elagolix provides effective, well-tolerated symptom relief in both pelvic and extra-pelvic endometriosis, supporting its role as a non-surgical, individualized therapeutic option.
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Abstract

Background: Endometriosis affects approximately 10% of reproductive-age women and manifests as chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility [1]. While ovarian endometrioma is frequently recognized, extra-ovarian forms such as peritoneal, deep infiltrating (DIE), and extra-pelvic endometriosis (e.g., umbilical or surgical scar lesions) represent clinically significant but often underdiagnosed variants [2,3].

Objective

To evaluate the clinical effectiveness of elagolix in symptom control of both ovarian and extra-ovarian endometriosis.

Methods

This prospective, hospital-based observational study included 80 women (20–45 years) with clinically, ultrasonographically, or laparoscopically confirmed endometriosis. Participants received elagolix 150 mg once daily for six months. Pain scores (NRS 0–10), ovarian cyst volume, and regression of extra-pelvic lesions were evaluated at baseline, 3 months, and 6 months.

Results

Mean pain scores decreased from 8.1 ± 1.0 to 2.9 ± 1.3 (p < 0.001). Pain reduction occurred across all subtypes—ovarian (63.9%), peritoneal (60%), DIE (62%), umbilical (61%), and scar endometriosis (59%). Ovarian cyst volume decreased modestly (mean 18%). Umbilical and scar lesions showed regression of swelling and cyclic bleeding. Adverse effects were mild and self-limiting.

Conclusion

Elagolix provides effective, well-tolerated symptom relief in both pelvic and extra-pelvic endometriosis, supporting its role as a non-surgical, individualized therapeutic option. Files Elagolix-Beyond-the-Ovary-A-Novel-Approach-to-Endometriosis- Management-2026.pdf Files (335.9 kB) | Name | Size | Download all | |---|---|---| | md5:dbee583d7ce5b43e5378ffecbca378cb | 335.9 kB | Preview Download | Additional details Dates - Accepted - 2026-01-03

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Outcome instruments

NRS-pain

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endometriosisdie_deep_infiltratingendometriomachronic_pelvic_paindysmenorrheadyspareuniainfertility

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