Given this scenario, we decided to undertake a systematic review of the available evidence published in the last decades on alternative modalities of GnRH agonists use for symptomatic endometriosis, to verify whether it would be possible to reduce pharmacological expenditure without compromising efficacy and, if this is the case, which is the best therapeutic approach in terms of trade-offs between financial, disease and treatment burdens. Here, GNRH1 is linked to endometriosis.