Digital illustration symbolizing medical solutions for uterine fibroids

Elagolix: A New Hope for Women Battling Heavy Menstrual Bleeding and Uterine Fibroids

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Jordan Keane in Health & Wellness December 2025 • 4 min read.

"Discover how Elagolix, with and without add-back therapy, offers a groundbreaking solution for managing heavy bleeding and improving quality of life for women with uterine leiomyomas."


Uterine leiomyomas, commonly known as fibroids, are benign tumors that grow in the uterus. They are incredibly common, affecting up to 70% of women by the time they reach 50 years of age. While not cancerous, these fibroids can cause a range of distressing symptoms, significantly impacting a woman's quality of life.

One of the most common and disruptive symptoms is heavy menstrual bleeding, also known as menorrhagia. This can lead to anemia, fatigue, and a general feeling of being unwell. Other symptoms include pelvic pain and pressure, frequent urination, and gastrointestinal issues. In some cases, fibroids can also contribute to infertility and pregnancy complications.

Historically, the management of uterine fibroids has often involved surgical interventions such as hysterectomy or myomectomy, or short-term medical treatments with limited efficacy and significant side effects. However, a recent study published in "Obstetrics & Gynecology" sheds light on a promising new option: elagolix, an oral gonadotropin-releasing hormone (GnRH) receptor antagonist.

What is Elagolix and How Does it Work?

Digital illustration symbolizing medical solutions for uterine fibroids

Elagolix is a nonpeptide, orally administered GnRH receptor antagonist. In simpler terms, it works by reducing the production of estrogen and progesterone, the hormones that fuel the growth of uterine fibroids. By lowering these hormone levels, elagolix can help shrink fibroids and alleviate the associated symptoms, particularly heavy menstrual bleeding.

The study, a randomized, double-blind, placebo-controlled trial, investigated the efficacy and safety of elagolix, with and without add-back hormone therapy, in premenopausal women experiencing heavy menstrual bleeding (more than 80 mL per month) due to uterine leiomyomas. Add-back therapy involves adding small doses of estrogen and progestin to mitigate the side effects of low estrogen levels caused by elagolix alone.

  • Participants: 571 women were enrolled and randomized.
  • Dosage: Participants received either elagolix alone (300 mg twice daily or 600 mg daily) or elagolix with add-back therapy (estradiol and norethindrone acetate).
  • Duration: The treatment period lasted for six months, followed by a post-treatment period of up to six months.
  • Measurement: Menstrual blood loss was objectively quantified, and changes in bone mineral density were assessed.
The study revealed that elagolix, both with and without add-back therapy, significantly reduced menstrual blood loss compared to the placebo. A remarkable 92% of women in the elagolix-alone group and 85% in the elagolix with add-back therapy group experienced a reduction in menstrual blood loss to less than 80 mL per month. These results marked a significant improvement in hemoglobin levels and substantial reduction in fibroid and uterine volumes

Looking Ahead: Elagolix as a Long-Term Solution

The study's findings suggest that elagolix is a promising treatment option for women with heavy menstrual bleeding associated with uterine fibroids. Its ability to reduce bleeding, improve hemoglobin levels, and shrink fibroid size offers a comprehensive approach to managing this common condition. The addition of add-back therapy can further mitigate the side effects of estrogen deficiency, making it a well-tolerated and effective option for long-term use.

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Everything You Need To Know

1

What is Elagolix, and how does it help women with uterine fibroids?

Elagolix is a nonpeptide, orally administered gonadotropin-releasing hormone (GnRH) receptor antagonist. It works by decreasing the production of estrogen and progesterone, the hormones that fuel the growth of uterine fibroids. By lowering these hormone levels, Elagolix shrinks fibroids and alleviates associated symptoms, particularly heavy menstrual bleeding.

2

What are uterine leiomyomas, and how do they impact a woman's health?

Uterine leiomyomas, commonly known as fibroids, are benign tumors that grow in the uterus. They are very common, affecting up to 70% of women by age 50. These fibroids can cause heavy menstrual bleeding (menorrhagia), leading to anemia and fatigue. Other symptoms include pelvic pain, pressure, frequent urination, and gastrointestinal issues. In some cases, fibroids can also contribute to infertility and pregnancy complications.

3

How does add-back therapy work in conjunction with Elagolix?

Add-back therapy involves supplementing Elagolix treatment with small doses of estrogen and progestin. The main goal of add-back therapy is to mitigate the side effects that can come from having low estrogen levels, a result of Elagolix treatment. By adding these hormones back, it can help make Elagolix a more tolerable treatment option, especially for longer-term use.

4

What were the key findings of the study on Elagolix and heavy menstrual bleeding?

The study showed that Elagolix, both with and without add-back therapy, significantly reduced menstrual blood loss compared to a placebo. The study found that a remarkable 92% of women in the Elagolix-alone group and 85% in the Elagolix with add-back therapy group experienced a reduction in menstrual blood loss to less than 80 mL per month. This outcome led to improved hemoglobin levels and reductions in both fibroid and uterine volumes.

5

What are the implications of using Elagolix for women with uterine fibroids, and is it a long-term solution?

Elagolix presents a promising treatment option for women with heavy menstrual bleeding associated with uterine fibroids. It reduces bleeding, improves hemoglobin levels, and shrinks fibroid size, offering a comprehensive approach to managing this condition. The addition of add-back therapy can help mitigate side effects, making Elagolix a well-tolerated and potentially effective option for long-term use, though long-term studies are necessary to determine its long-term efficacy and safety profile.

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