The endometriosis therapeutics market continues to face significant unmet needs, primarily due to low diagnosis rates, limited disease awareness, and a lack of well-tolerated, long-term treatment options. A major hurdle is the considerable delay between symptom onset and diagnosis, which often spans several years. This delay allows the disease to progress unchecked, leading to complications such as chronic pelvic pain (CPP) and infertility. While surgical interventions can offer symptomatic relief, they are costly and do not guarantee long-term remission or prevention of recurrence. Moreover, patients often undergo multiple surgeries throughout their reproductive years due to symptom recurrence and limited treatment durability.
Current pharmacological treatments—such as gonadotropin-releasing hormone (GnRH) agonists, hormonal contraceptives, and progestins—primarily function by suppressing oestrogen production or modulating the menstrual cycle. However, these therapies do not adequately address the underlying mechanisms of the disease. Their benefits are typically temporary, with symptoms returning after discontinuation. Over time, the effectiveness of these treatments may decrease, and patients often report persistent pain alongside significant side effects. This can severely impact adherence and overall quality of life, pushing many toward surgical solutions despite their risks. A further drawback of these hormone-based therapies is their impact on fertility, which is suppressed for the duration of treatment—posing a major concern for women of reproductive age.
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Progress in endometriosis care remains significantly hindered by five critical unmet needs. First, there is an urgent demand for non-invasive diagnostic tools that would allow for earlier and more accessible detection of the disease. KOLs interviewed by GlobalData have stated that this unmet need can be addressed by testing biomarkers in blood, urine, saliva, or menstrual fluid, which can indicate the presence of endometriosis before the lesions are visible, allowing for early detection and reduction of diagnostic delay. A biomarker-based blood test could serve as a first-line screening tool, reducing unnecessary surgeries.
Second, improved awareness and education among healthcare professionals are essential to reduce the diagnostic delays that many patients face. KOLs have stated this can be addressed by educating patients about the symptoms they can expect, what dysmenorrhea is, and what endometriosis is.
Third, more effective pharmacological treatments are needed—therapies that not only provide long-term relief but also offer better safety and tolerability profiles. One expert highlighted a critical gap, noting that while current therapies—particularly GnRH antagonists—are effective, their approved duration of use in the US is limited to just two years. “Long-term durable, because most of the medication I mentioned, especially the good ones—the effective ones, like GnRH antagonists—are approved in the US only for two years, at least officially,” they explained. Despite some clinicians prescribing these medications off-label beyond the approved period and even receiving continued insurance coverage for them, this practice is not universal.
“Surprisingly, insurance companies cover them after two years… but some doctors are not comfortable doing that,” the KOL added. This hesitancy, combined with regulatory limitations and high treatment costs, underscores the urgent need for long-term therapeutic options that clinicians can prescribe with confidence and patients can access without financial or clinical uncertainty.
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By GlobalDataFourth, the development of non-hormonal therapies is crucial, particularly those that can preserve fertility and minimise side effects. Finally, a deeper understanding of the disease’s aetiology and pathophysiology is necessary to drive innovation and enable more targeted interventions. HMI-115 is currently in development as a prolactin receptor antagonist, offering potential benefits as a non-hormonal therapy.
While some promising products and initiatives are currently in development, the need for transformative solutions remains pressing. Addressing these unmet needs will not only improve outcomes for patients but also expand the diagnosed and treated population, thereby supporting sustainable growth in the endometriosis therapeutics market.
