Surgery has long been the default choice when managing uterine fibroids and endometriosis. However, over the past few years, reliable and durable medical interventions have emerged, notably GnRH antagonist therapy. Clinical trial data for GnRH antagonists highlight both their safety and efficacy for a broad demographic of patients. Join Drs. Lee Shulman and Ayman Al-Hendy as they discuss the “how” and the “why” of a paradigm shift that is occurring, changing our focus from surgery to first-line medical intervention for uterine fibroids and endometriosis.