The first daily tablet for long-term treatment of endometriosis has been approved for use on the NHS.

The drug could help about a thousand women a year who suffer from the debilitating condition.

The National Institute for Health and Care Excellence (NICE) has recommended relugolix-estradiol-norethisterone (also known as relugolix combination therapy or Ryeqo) for routine NHS use after initially rejecting the drug.

Endometriosis affects around 1.5 million women in the UK, causing chronic pain and fatigue due to tissue similar to the womb lining growing elsewhere in the body. The cells respond to the menstrual cycle, building up and then breaking down and bleeding, but the blood has no way to escape.

Despite being widespread – one in ten women and girls of reproductive age are affected, according to the World Health Organisation – diagnosis can take around a decade. There is also no known cure, but treatment can ease symptoms.

But current injectable treatments can initially worsen symptoms.

This new tablet starts working faster, can be taken at home, combines all the hormones needed in a single pill and returns hormone levels to previous levels faster when stopped. It also doesn’t require the woman to make regular clinic visits.

It will be available for patients for whom medical and surgical treatments have failed.

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A ‘potential step-change’ in treating endometriosis

Helen Knight, director of medicines evaluation at NICE, said: “This new treatment marks a potential step-change in how we manage endometriosis, putting control back in patients’ hands while ensuring value for the taxpayer.

“Instead of travelling to clinics for injections, there is now a daily tablet that can be taken at home.

“The treatment can also be stopped and started more easily, which is particularly important for those planning to have children and for managing side effects. This convenience not only benefits patients but reduces pressure on NHS services.”

The list price for the treatment is £72 for a 28-day supply (excluding VAT).

Dr Sue Mann, NHS national clinical director for women’s health, said: “This first-of-a-kind treatment for endometriosis… will give women greater control of their own health by potentially allowing them to get the treatment they need in the comfort of their own homes, without the need to attend regular appointments.”

Warning: This article contains material some readers may find distressing

Jane* served in the British Army for almost 20 years. It was a career she loved and excelled in, rising through the ranks. But then, she says, it ended when a colleague raped her.

She breaks down as she recalls the night out, almost six years ago.

Jane reported the attack to the Royal Military Police but days later was called into a meeting with officers in her chain of command and accused of flirting with men and drinking too much. Later, she discovered messages they had exchanged calling her a whore.

The military police investigated, but the case never made it to court martial, where military trials are heard – she was told there was an unrealistic chance of conviction.

Her case formed part of a legal process to try to force the previous government to transfer rape investigations in the armed forces to civilian courts, but the change was voted down in parliament.

Now, a high-profile former defence minister, and veteran, who failed to back the move has admitted he got it wrong.

Johnny Mercer has told Sky News that he, and other members of the previous government, must accept their part in the “colossal failure of leadership across all ranks” to deal with sexual abuse in the army.

Three female veterans have shared their stories with Sky News.

A toxic culture where abuse is rife

When 19-year-old soldier Jaysley Beck took her own life in December 2021, hundreds of servicewomen shared their experiences on social media, describing a toxic culture where sexual abuse is not only rife but tolerated.

The inquest into Gunner Beck’s death last month found she had been sexually assaulted and then failed by the army when she reported it. This prompted the change of heart from Johnny Mercer.

“I should have argued harder for serious and sexual offences to be taken away from the MoD to civilian police,” he told Sky News. He has now called on the current government to act, saying “now is the time to make that change”.

Hayley* was a new recruit when she reported witnessing a female colleague being sexually assaulted by a senior officer.

She said at first “he didn’t say anything”. Then “he dragged me by the back of my coat, up the stairs to the office. I knew I couldn’t keep up, and I remember falling over my knees, like dragging on the floor”.

She continued: “He stood over me with his finger right in my face, screaming and swearing – like he was screaming so much he was spitting – and he was saying ‘don’t you dare speak about that ever again’.

“I remember thinking there’s girls who are at risk here, anything can happen to them and nobody cares.”

Months later, she was woken up by a male colleague climbing into her bed.

“He was trying to kiss my face and touch me,” she said, her voice trembling. “I was moving my head and saying: ‘you need to go’.”

She reported it to the Royal Military Police.

“I remember them being so condescending.”

They asked her if she had been drinking, if she had locked her door and if she had encouraged him.

“It did eventually get dropped because there wasn’t enough evidence against him.”

‘I was left with bruising on my neck’

Michelle, who left the army in 2020 after 11 years that included active service in Afghanistan, said sexual harassment went on “all the time”.

“I’ve had my breasts grabbed by people…Guys when I’ve walked upstairs have looked up my skirt to see if I’m wearing underwear,” she said.

“Disgusting stuff like that”.

Jane said her attacker was someone she knew.

“He was trying to kiss me, and I was pushing him away. He grabbed at my throat and was pushing me down on to this blow-up bed. And then he was trying to put his penis in my mouth,” she said.

“I had bruising to both my arms and also on my neck.

“It was the worst experience I’ve ever been through. I loved my career and never wanted to leave my job. I nearly lost everything, including my mental health. I wanted to end it all.”

The Royal Military Police investigated but the case did not go to court martial because, Jane was told, there was an unrealistic possibility of conviction.

Call to remove sexual offences from military court

Campaigners have been urging politicians for years to remove sexual offence cases from the military justice system.

“The conviction rate for cases that get to court martial for rapes and serious sexual assault is far lower than the equivalent figures in the Crown Court,” said Emma Norton, a lawyer who established the Centre for Military Justice.

“That, on the face of it, is a serious difference that is completely unjustifiable.”

In opposition, Labour backed the proposal to transfer serious and sexual offences out of military courts. Sky News asked the Ministry of Defence (MoD) if it intends to make the legal change but it did not reply to the question.

A spokesperson for the MoD said: “There is no place for bullying, harassment or discrimination in the military. This government is totally committed to making the reforms that are needed to stamp out inappropriate behaviour and hold people to account.”

Their experiences have left many women conflicted about their time in the army.

“I had some of the best and also worst times of my life… that’s hard to reconcile,” said Hayley.

“I don’t want to look back and feel sorry for myself, but I feel the younger version of myself was severely let down by the people who were in authority at the time.

“It’s not acceptable for this to be happening.”

*Names have been changed

Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK

A teenager with severe cerebral palsy who wrote a book using his eyes has urged teachers not to underestimate their pupils.

When Jonathan Bryan started school he was given the label PMLD, which stands for profound and multiple learning disabilities.

It meant he was placed on a sensory curriculum – essentially early years education – but his mother took him out of school and taught him to read and write using an alphabet board.

Mr Bryan told The UK Tonight With Sarah-Jane Mee he has become a “voice of the voiceless” over 10 years of campaigning to prevent people with complex needs and who are non-verbal from being overlooked.

The 19-year-old is now a published author and is studying creative writing at Bath Spa University.

Asked if the school system was underestimating children with PMLD, he said the mistake was in thinking “it’s something that’s diagnosed” when it is “just an educational label given to children who look like me – usually in a wheelchair, with little or no means of communication”.

“Our cognition isn’t tested before we get the label, but we are treated like we all have a profound intellectual disability,” he said. “We’re not taught to read or write because it’s assumed we’ll never learn. It’s a self-fulfilling prophecy. We don’t learn because we aren’t taught.”

He said “people look at us and make assumptions about our capacity to learn”.

“When you don’t speak out loud, people assume your intellect is the same as a pre-verbal toddler. Because we don’t speak, it’s easier to ignore us. It’s why I speak up about this as a voice for the voiceless.”

After a decade of campaigning, Mr Bryan said there is “still a long way to go”.

“Until the government expects this cohort to be taught literacy, it’s down to individuals and schools to raise their expectations,” he said.

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‘Please don’t underestimate your pupils’

Asked what his life would have been like if his mother had not taught him to read and write using an alphabet board, he said: “I’d rather not think about it. I’d be left to my own thoughts and unable to communicate everything I can now. It’s difficult imagining how lonely and boring that would be.”

Mr Bryan had a message for those who might underestimate people with similar needs.

“If you are a teacher watching this, please don’t underestimate your pupils,” he said. “Anyone else, please remember, non-speaking is not the same as non-thinking.”

He encouraged people who are non-speaking and “have a story of how you learnt to read and write” to contact the charity he founded, Teach Us Too.

A Department for Education spokesperson said: “We are determined to break down the barriers to opportunity to ensure all young people with SEND, like Jonathan, can achieve and thrive. This includes making sure every child has a strong foundation in reading and writing as part of our Plan for Change.

“The system we’ve inherited has been failing to meet the needs of children and families for far too long and we are determined to improve inclusivity and expertise in mainstream schools, making sure special schools cater to children with the most complex needs.”