Relugolix is an oral GnRH antagonist that has been recently demonstrated to provide significant improvement to a number of fibroid-related symptoms including menstrual blood loss, pain, anaemia, and uterine volume; it can be given in combination with oestradiol and progestogen, which mitigates risk of bone density loss and some of the menopausal symptoms associated with GnRH agents (Al-Hendy et al., 2021; Baird and Harmon, 2021). This evidence concerns the gene GNRH1 and leiomyoma.