Current drugs in the pipeline pose new possibilities for improvement to the treatment of sufferers; with the third generation of endocrine drugs having considerable improvements over those from the past. It appears that the invasive nature of endometriosis still leads to an overlap with cancer therapies and chronic inflammatory conditions. There is an opportunity in endometriosis, although to get a truly bespoke therapy for which there is both a sizable market and unmet medical need it may be necessary for a small company to raise interest. As a result of this, there has probably never been an indication more suited to transitional pharma. The main reason for failure of drugs is either that they do not work or are too toxic. In order to be successful in the passage of a compound to release, every new drug must address a clear unmet medical need or represent a significant refinement of current therapies, especially where cheap off license generics provide some disease coverage. The minimal drug product profile is a further consideration both in terms of marketability and function; given the severity of the condition, what course duration, dosing regimen or route of administration are acceptable? There is a real opportunity/need for transitional pharma to take the lead in endometriosis, combining new academic ideas from research with in situ knowledge from the clinic, to create new directions in this poorly supported indication. The transitional option could provide the necessary high quality product validation and as such any subsequent package would undoubtedly prove highly attractive to the larger pharmaceutical industry.