Elagolix Versus Relugolix in Treating Endometriosis: A Comparative Study

Background: Endometriosis is a chronic gynecological disorder characterized by ectopic endometrial tissue, commonly causing pelvic pain, dysmenorrhea, dyspareunia, and infertility, leading to significant impairment in quality of life. Traditional hormonal therapies are limited by suboptimal efficacy and adverse effects. Recently, oral GnRH antagonists such as elagolix and relugolix have emerged as effective options, offering rapid, reversible estrogen suppression and meaningful reduction of endometriosis-associated pain. Objective: To compare the efficacy and safety of Elagolix and Relugolix in managing endometriosis-related pain. Methodology: A comparative study was conducted on 120 women with confirmed endometriosis, randomized into two groups (60 receiving Elagolix, 60 receiving Relugolix). Demographics, symptoms, and side effects were recorded. Pain reduction was assessed after treatment, and safety profiles were compared. Results: Dysmenorrhea (75.83%) and chronic pelvic pain (68.33%) were the most common presenting symptoms. Both drugs significantly reduced pain severity: however, relugolix demonstrated greater overall symptom improvement, with a higher proportion of patients experiencing mild residual symptoms and fewer reporting severe pain (p = 0.009). Hypoestrogenic adverse effects, including hot flushes and vaginal dryness, were significantly more frequent in the elagolix group (p = 0.04), while other side effects showed no significant difference. Conclusion: Both elagolix and relugolix are effective in reducing endometriosis-associated pain. Relugolix, however, demonstrated superior tolerability and greater overall symptom improvement, suggesting it may be a more suitable option for long-term management.