GNRH1 and Salla disease: For SD, two RCTs showed that COCs and TCM were comparable for reducing symptoms of dysmenorrhea,36,38 while another three RCTs showed that TCM was more effective than COCs.33–35 Two studies39,49 that compared COCs versus GnRH agonists showed that GnRH agonists were more effective than cyclic COCs for reducing symptoms of dysmenorrhea; however, another study39 reported that continuous COCs were comparable with GnRH agonist.