The currently available non-surgical interventions include GnRH analogs, which cause prolonged suppression of pituitary gonadotropins but are not Food and Drug Administration-approved for long-term use and cause significant side effects including menopausal symptoms, and progesterone receptor modulators, which temporally relieve symptoms but are not available in the United States and have been associated with liver failure in Europe [2, 3]. This evidence concerns the gene GNRH1 and liver failure.