GNRH1 and adenomyosis: In the view of Vannuccini and Petraglia [15,16], and Cope et al. [14], use of a gonadotropin-releasing hormone (GnRH) agonist for management of adenomyosis-related pain and bleeding should be considered as second-line therapy, and only for short-term administration because of its severe hypoestrogenic side effects, initial flare-up effect, and slow reversibility.