An evidence based consult guide for general practitioners.
Key points
- Endometriosis affects 1 in 7 women in Australia1.
- In Australia, many women experience delays receiving a diagnosis of endometriosis. However, recent evidence shows that the time to diagnosis is decreasing as awareness and clinical practice improves2,3.
- The economic and social impact of pelvic pain is underestimated, with significant effects on workforce participation and quality of life4.
- Women with endometriosis are around twice as likely to have trouble getting pregnant as those without the disease5.
- Timely diagnosis is essential for effective endometriosis management, allowing early, multidisciplinary care tailored to patient priorities6.
Practice considerations
- Follow recommendations as described in the Australian Living Evidence Guideline: Endometriosis, including recommendations for diagnosis, education and management
- Consider probable risk factors, such as genetics, autoimmune disease, low birth weight, early age at first period, low BMI, short menstrual cycles, increased menstrual flow. More research is needed to better understand the factors that increase a person’s risk for endometriosis7,8.
- Based on current available evidence, women with endometriosis may be more likely than those without to experience:
- Depression and anxiety9
- Other chronic pain conditions such as migraine10
- Uterine fibroids (non-cancerous tumours that grow into the wall of the uterus)11
- Adenomyosis (where tissue that normally lines the uterus grows into the uterine muscle wall)12
- Ovarian, breast, endometrial, and thyroid cancer, although the absolute increase in risk is small13,14,15
- Autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis, or inflammatory bowel disease16
- Early menopause, both natural17 and surgical18
- Cerebrovascular disease (e.g. stroke) and cardiovascular disease19,20
- Encourage patients to keep a short-term symptom diary
- Assess the impact of endometriosis and potential management methods on quality of life to guide treatment decisions and improve patient outcomes9
- Referral to a specialist should be considered where appropriate6
Further reading for GPs
- RANZCOG Australian Living Evidence Guideline: Endometriosis
- Endometriosis: A review of recent evidence and guidelines RACGP – AJGP (Australian Journal of General Practice)
- Endometriosis, What is endometriosis? – Australian Institute of Health and Welfare
Patient health information
Jean Hailes resources
From Endometriosis Australia
References
1. Australian Institute of Health and Welfare. Endometriosis Web Report. Australian Institute of Health and Welfare; 2023. Accessed December 13, 2024. https://www.aihw.gov.au/reports/chronic-disease/endometriosis-in-australia/contents/summary
2. Armour M, Sinclair J, Ng CHM, et al. Endometriosis and chronic pelvic pain have similar impact on women, but time to diagnosis is decreasing: an Australian survey. Sci Rep. 2020;10(1):16253. doi:10.1038/s41598-020-73389-2
3. Mosterd D, Evans S, Van Niekerk L, et al. ‘A name to the pain’: A mixed methods analysis of diagnostic delay and perceptions of diagnosis importance in Australians with endometriosis. Journal of Psychosomatic Research. 2025;193:112143. doi:10.1016/j.jpsychores.2025.112143
4. Jean Hailes for Women’s Health. Pelvic Pain in Australian Women.; 2023. https://www.jeanhailes.org.au/uploads/15_Research/2023-National-Womens-Health-Survey-Pelvic-Pain-in-Australia-FINAL_TGD.pdf
5. Missmer SA, Tu FF, Agarwal SK, et al. Impact of Endometriosis on Life-Course Potential: A Narrative Review. Int J Gen Med. 2021;14:9-25. doi:10.2147/IJGM.S261139
6. Crump J, Suker A, White L. Endometriosis: A review of recent evidence and guidelines. Australian Journal of General Practice. 2024;53:1-2. doi: 10.31128/AJGP/04-23-6805
7. Zondervan KT, Becker CM, Missmer SA. Endometriosis. New England Journal of Medicine. 2020;382(13):1244-1256. doi:10.1056/NEJMra1810764
8. Crump J, Suker A, White L. Endometriosis: A review of recent evidence and guidelines. Aust J Gen Pract. 2024;53(1-2):11-18. doi:10.31128/AJGP/04-23-6805
9. van Barneveld E, Manders J, van Osch FHM, et al. Depression, Anxiety, and Correlating Factors in Endometriosis: A Systematic Review and Meta-Analysis. Journal of Women’s Health. 2022;31(2):219-230. doi:10.1089/jwh.2021.0021
10. Gete DG, Doust J, Mortlock S, Montgomery G, Mishra GD. Associations between endometriosis and common symptoms: Findings from the Australian Longitudinal Study on Women’s Health. American Journal of Obstetrics & Gynecology. 2023;229(5):536.e1-536.e20. doi:10.1016/j.ajog.2023.07.033
11. Gallagher CS, Mäkinen N, Harris HR, et al. Genome-wide association and epidemiological analyses reveal common genetic origins between uterine leiomyomata and endometriosis. Nat Commun. 2019;10:4857. doi:10.1038/s41467-019-12536-4
12. Upson K, Missmer SA. Epidemiology of Adenomyosis. Semin Reprod Med. 2020;38(2-03):89-107. doi:10.1055/s-0040-1718920
13. Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Australian Living Evidence Guideline: Endometriosis. Published online 2025. Accessed May 30, 2025.
14. Kvaskoff M, Mahamat-Saleh Y, Farland LV, et al. Endometriosis and cancer: a systematic review and meta-analysis. Human Reproduction Update. 2021;27(2):393-420. doi:10.1093/humupd/dmaa045,27
15. Ye J, Peng H, Huang X, Qi X. The association between endometriosis and risk of endometrial cancer and breast cancer: a meta-analysis. BMC Womens Health. 2022;22:455. doi:10.1186/s12905-022-02028-x
16. Shigesi N, Kvaskoff M, Kirtley S, et al. The association between endometriosis and autoimmune diseases: a systematic review and meta-analysis. Human Reproduction Update. 2019;25(4):486-503. doi:10.1093/humupd/dmz014
17. Thombre Kulkarni M, Shafrir A, Farland LV, et al. Association between laparoscopically confirmed endometriosis and risk of early natural menopause. JAMA Network Open. 2022;5(1):e2144391. doi:10.1001/jamanetworkopen.2021.44391
18. Chung HF, Hayashi K, Dobson AJ, et al. Association between endometriosis and type and age of menopause: a pooled analysis of 279 948 women from five cohort studies. Human Reproduction. Published online April 30, 2025:deaf068. doi:10.1093/humrep/deaf068
19.31Poeta do Couto C, Policiano C, Pinto FJ, Brito D, Caldeira D. Endometriosis and cardiovascular disease: A systematic review and meta-analysis. Maturitas. 2023;171:45-52. doi:10.1016/j.maturitas.2023.04.001,
20. Colombo GE, Mahamat-Saleh Y, Armour M, et al. Non-malignant gynaecological disease and risk of cardiovascular or cerebrovascular disease: a systematic review and meta-analysis. Heart. Published online January 21, 2025. doi:10.1136/heartjnl-2024-324675
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Evidence and medical knowledge is constantly changing. The authors have taken care to ensure that the information on this page is accurate and up to date at the time it was created. This content is intended for healthcare professionals who should always manage patients within their scope of practice and work within local policies and practices. This content is not intended for members of the general public.
