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First-of-its-kind study gives ‘baseline’ for endometriosis diagnosis
It reveals diagnoses with a GP doubled across a decade, serving as a benchmark to improve clinical management and outcomes.
Women who were referred for pelvic ultrasound by their GP prior to endometriosis diagnosis grew from 18.9% to 48.6% across 10 years.
An Australian-first study backs calls for improved support for GPs in identifying and managing endometriosis to reduce diagnosis delays and enhance clinical care.
Published in the Medical Journal of Australia, Monash University’s SPHERE Centre of Research Excellence study reveals that women diagnosed with endometriosis at a general practice almost doubled over a 10-year period, with the median time from first symptoms to diagnosis 2.5 years.
And while GPs are the first point of contact with the health system for most women, the authors say ‘little is known’ about endometriosis presentation and management in general practice, particularly as women can present with a broad range of symptoms.
Across 2700 clinics, almost 20,000 women aged 14–49 received care from 660 GPs for the condition, diagnosed at their regular practice between January 2011 – December 2021.
For the ‘often debilitating condition’ estimated to impact one in seven Australian women, the study authors say their findings provide ‘unique insights’ into its presentation and help to inform interventions to improve clinical management and outcomes.
Women’s health expert Professor Danielle Mazza is the study lead and SPHERE Director. She told newsGP the prevalence of endometriosis in general practice represents two things.
‘Increased community awareness of endometriosis is driving women to seek care, but also, probably increasing awareness in general practice of endometriosis,’ she said.
‘And both of those are good things.’
The new study’s results show that of the 19,786 women diagnosed with endometriosis between 2011–21, at least one symptom was documented prior to diagnosis for 66.7%, including 40.8% with pelvic pain and 22.1% with dysmenorrhea.
Professor Mazza said another key takeaway is GPs’ use of pelvic ultrasound, with the proportion of women who had pelvic ultrasound requested by their GP prior to diagnosis growing significantly from 18.9% of those diagnosed in 2011 to 48.6% in 2021.
‘That’s also a good thing because it’s concordant with current national guideline recommendations that say pelvic ultrasound is a good tool to use in primary care to assist in the diagnosis and management of endometriosis,’ she said.
In collaboration with the RACGP and funded by the Federal Government’s National Action Plan for Endometriosis, development of SPHERE’s national Endometriosis Management Plan (EMP) is currently being piloted in general practices across the country. Following the evaluation of the pilot, the EMP is expected to be rolled out to all primary care settings in May 2026.
With the SPHERE study conducted as part of development of the plan, Professor Mazza said the findings provide important insights for implementation of the EMP.
‘This will help us to understand perhaps where the areas of emphasis should be, as the management plan is going to translate the guidelines into practice, hopefully, by showing GPs and patients what the guideline recommendations say and building those recommendations into the plan,’ she said.
‘This gives us the baseline – and we’d like to look at what the outcomes are after our patients have had an opportunity to use the management plan and have that in place for them.’
Despite current national guidelines recommending hormonal contraception among first-line therapy for endometriosis management, the study saw an increase in prescribing of opioids and gabapentinoids post-endometriosis diagnosis, which Professor Mazza says ‘aren’t necessarily a good way to go’.
‘We would have hoped that more women would have been helped by earlier therapies than having to resort to those kinds of medications,’ she said.
‘While we have evidence of some increase in the prescribing of hormonal contraception post-endometriosis diagnosis, it wasn’t to the extent that we perhaps would have hoped.
‘There’s room for further examination and perhaps some improvements.’
With women attending general practice first with their symptoms, the study marks a step forward in supporting both patients and GPs in the diagnosis and treatment of endometriosis.
‘This is an important baseline study, we haven’t had this kind of data locally, and it is rare internationally to see what’s going on with endometriosis in general practice,’ Professor Mazza said.
‘Our colleagues in the UK and in Europe are … keen to see the paper, because we’re one of the first countries to publish what’s happening in general practice.
‘That’s really important – and there’s a lot more GPs can be doing in terms of ultrasounds and instituting the hormonal first-line therapies when women first present with these symptoms to help them to get the management they need.’
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