Endometriosis in Australia: When to See a Doctor and How Telehealth Can Help
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Endometriosis is a condition in which tissue similar to the lining of the uterus, the endometrium, grows outside the uterus in other areas of the body. The most common sites include the ovaries, the fallopian tubes, the peritoneum (the tissue lining the pelvic cavity), and the surface of the bowel and bladder. In rarer cases, endometrial-like tissue has been found in more distant locations, including the diaphragm.
This tissue responds to the hormonal changes of the menstrual cycle in much the same way the uterine lining does. It thickens, breaks down, and bleeds with each cycle. But because it is located outside the uterus, the blood and tissue have no way to exit the body. The result is inflammation, the formation of scar tissue known as adhesions, and the development of cysts on the ovaries known as endometriomas. Over time, adhesions can bind organs together, distort pelvic anatomy, and cause significant, persistent pain.
Endometriosis is classified into four stages by the American Society for Reproductive Medicine, ranging from Stage I (minimal) to Stage IV (severe), based on the location, extent, and depth of the tissue growth and the presence of adhesions and endometriomas. However, staging does not reliably correlate with the severity of symptoms. A woman with Stage I endometriosis can experience excruciating pain, while a woman with Stage IV disease may have relatively mild symptoms. This disconnect between visible disease and lived experience is one of the reasons endometriosis is so frequently underestimated.
The exact cause of endometriosis is not fully understood. The most widely discussed theory is retrograde menstruation, in which menstrual blood flows backwards through the fallopian tubes into the pelvic cavity. While retrograde menstruation occurs in most women, only a subset develop endometriosis, suggesting that additional factors are involved. Current research from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists points to immune system dysfunction, genetic predisposition, and possibly environmental factors. Women with a first-degree relative who has endometriosis are significantly more likely to develop the condition themselves.
The symptoms of endometriosis vary considerably between individuals, which is part of what makes the condition difficult to identify without clinical investigation. Some women experience severe, life-altering symptoms from adolescence. Others may have few obvious signs until they begin trying to conceive. Understanding the range of symptoms that can indicate endometriosis is an important first step toward seeking the right help.
Pelvic pain is the hallmark symptom, and while it is often most intense during menstruation, it is not limited to that time of the month. Many women with endometriosis experience chronic pelvic pain that persists throughout their cycle, sometimes worsening at ovulation or in the days leading up to a period. The pain may be sharp, stabbing, or a deep aching pressure in the lower abdomen. It is not the same as ordinary period pain, and it frequently does not respond to over-the-counter pain relief such as paracetamol or ibuprofen.
Heavy menstrual bleeding is another common symptom, with some women also experiencing bleeding between periods. Pain during or after sexual intercourse, known clinically as dyspareunia, affects a significant proportion of women with endometriosis and can have a profound impact on intimate relationships and emotional wellbeing. Pain with bowel movements or urination, particularly during menstruation, may indicate that endometrial-like tissue is affecting the bowel or bladder.
Beyond pain, endometriosis is frequently associated with debilitating fatigue that goes well beyond normal tiredness. Bloating, sometimes so pronounced that women refer to it as "endo belly," is common. Difficulty falling pregnant is often the symptom that ultimately leads to diagnosis. According to the Australian Institute of Health and Welfare, endometriosis is found in up to 30 to 50 per cent of women experiencing infertility, though many women with endometriosis do conceive, either naturally or with medical assistance.
What matters most is this: pain severity does not determine disease severity, and the absence of visible pathology on an ultrasound does not mean endometriosis is not present. Many women have been told their pain is "normal" when it is not. If your symptoms are affecting your ability to attend work or school, participate in daily activities, or live without regular pain, that is a clinical concern that warrants investigation.
Knowing when to seek medical attention for symptoms that might indicate endometriosis is one of the most important decisions a woman can make for her long-term health. Menstrual pain exists on a spectrum, and the line between normal discomfort and pain that signals an underlying condition is not always obvious from the inside. There are, however, clear indicators that it is time to talk to a GP.
If period pain regularly prevents you from attending work, school, or social activities, that is not something to push through. If over-the-counter pain relief such as paracetamol or anti-inflammatory medications is not adequately managing your symptoms, your pain may require a clinical assessment to identify the cause. If your symptoms are worsening over time, either in intensity or duration, that progression itself is a reason to seek care. And if you have been trying to conceive for twelve months without success, or six months if you are over 35, a GP consultation is an important early step, as endometriosis is one of several conditions that may be contributing.
The GP is the gateway to diagnosis and treatment. During an initial assessment, your doctor will take a detailed history of your symptoms, their timing, severity, and impact on your daily life. They may conduct a physical examination and order initial investigations. Pelvic ultrasound can identify endometriomas and some deep infiltrating endometriosis, though it cannot detect all forms of the condition. Blood tests are not diagnostic for endometriosis but may be used to rule out other causes of your symptoms.
If your GP suspects endometriosis, they can refer you to a gynaecologist or endometriosis specialist for further assessment, which may include a laparoscopy. The National Action Plan for Endometriosis, released by the Australian Government Department of Health, emphasises the importance of GPs as the first point of clinical contact and the need for timely referral. You do not need to wait until your symptoms are unbearable. Early assessment and management can make a meaningful difference to quality of life and long-term outcomes.
There is currently no cure for endometriosis. This is a difficult reality, but it does not mean that symptoms cannot be effectively managed. Treatment is highly individualised, and the approach your GP and specialist team recommend will depend on the severity of your symptoms, whether you are trying to conceive, your response to previous treatments, and your own priorities for care. The goal is to reduce pain, slow disease progression where possible, and support quality of life.
Pain management is typically the first line of treatment. For mild symptoms, your GP may recommend prescription-strength anti-inflammatory medications or other analgesics that go beyond what is available over the counter. For pain that does not respond to these measures, your GP can discuss additional options as part of a broader management plan. All medication decisions are made by your treating clinician based on your individual circumstances.
Hormonal treatments form a central part of endometriosis management for many women. The combined oral contraceptive pill can be used to regulate the menstrual cycle and reduce the frequency and severity of painful episodes. Progestins, available in various forms including oral tablets, injections, and intrauterine devices, work by suppressing the growth of endometrial-like tissue. For more severe cases, GnRH analogues may be prescribed to temporarily suppress oestrogen production, creating a low-oestrogen state that can reduce endometriosis activity. These medications have significant side effects and are typically used for limited periods under specialist supervision. Your GP or specialist will explain the benefits and risks of each option in the context of your situation.
Surgical management is an important pathway for women whose symptoms are not adequately controlled by medication, or for whom a definitive diagnosis is needed. Laparoscopy, a minimally invasive surgical procedure, is both the gold standard for diagnosing endometriosis and the primary method for removing endometrial implants and adhesions. Excision surgery, performed by an experienced endometriosis surgeon, is considered the most effective surgical approach. Your GP plays a critical role in coordinating the referral and managing your care before and after surgery.
Allied health professionals are increasingly recognised as essential in endometriosis care. Pelvic floor physiotherapy can help address pelvic pain and muscle tension, while psychology and pain management support are valuable for women dealing with the chronic nature of the condition. A multidisciplinary approach, coordinated through your GP, offers the most comprehensive support.
For women experiencing difficulty conceiving due to endometriosis, your GP can initiate the referral process to a fertility specialist. Treatment options vary depending on the extent of the disease and individual factors. Early conversation with your GP about fertility concerns is recommended, even if conception is not an immediate goal, as it allows for better planning and timely intervention.
Endometriosis is a chronic condition that requires ongoing management and coordination across multiple aspects of care. For many women, particularly those in rural and remote Australia, accessing this care in person presents a significant logistical challenge. Telehealth has become a valuable part of the endometriosis care pathway, not as a replacement for hands-on clinical assessment and surgery, but as a complement that makes ongoing management more accessible.
The initial GP assessment for suspected endometriosis can take place via a telehealth consultation. A detailed symptom history, discussion of menstrual patterns, assessment of pain severity, and a review of family history can all be conducted effectively through video. Your GP can order blood tests and pelvic imaging remotely, with pathology and radiology providers in your local area. This means the diagnostic process can begin without travelling to a metropolitan clinic or waiting weeks for an in-person appointment.
Medication management is particularly well suited to telehealth. Hormonal treatments for endometriosis require ongoing monitoring, dose adjustments, and assessment of side effects. These review consultations can be conducted via video, with prescriptions sent electronically to your local pharmacy. For women managing their condition with hormonal therapy and experiencing stable symptoms, this reduces the burden of repeated in-person visits while maintaining clinical oversight.
Specialist referrals can be coordinated by your GP during a telehealth consultation. Your doctor can prepare referral letters, arrange imaging, and communicate with the specialist team without requiring you to be physically present. This is especially valuable for women in regional, rural, and remote Australia, where specialist endometriosis services may be hundreds of kilometres away. Endometriosis Australia has noted the potential for telehealth to reduce diagnostic delays, particularly for women outside major cities, by facilitating earlier GP engagement and faster referral pathways.
Ongoing symptom monitoring represents perhaps the greatest strength of telehealth for endometriosis. The condition is lifelong for many women, and the ability to check in regularly with a GP who knows your history, without needing to take a full day off work or arrange childcare, can make the difference between consistent management and care that falls through the gaps. Telehealth allows for regular reviews of pain management, hormonal treatment efficacy, and quality of life in a format that fits into real life.
It is important to be clear about what telehealth cannot do in the context of endometriosis. Physical examinations, including pelvic examinations, cannot be conducted remotely. Surgical procedures and certain diagnostic steps require in-person attendance. Telehealth is not a substitute for these elements of care. It is the connective tissue that holds the broader management plan together, ensuring that the intervals between in-person appointments are not gaps in care but periods of active, supported management.
If you have been living with symptoms that you suspect may be endometriosis, or if you have already been diagnosed and are looking for ongoing support, Abby Health can help you access the care you need.
Abby Health is an online-first clinic with more than 300 clinicians available seven days a week, 365 days a year. You can book a consultation from wherever you are in Australia, whether that is a capital city, a regional town, or a remote community where finding a GP can feel impossible. The consultation takes place over a secure video call with a GP who has access to your health history, so you do not need to repeat your story every time you seek care. For a condition like endometriosis, where the history of symptoms is clinically important, that continuity matters enormously.
During a consultation, your GP can conduct an initial assessment of your symptoms, discuss your pain history, order blood tests and imaging, provide or adjust hormonal treatments, and coordinate referrals to gynaecologists or endometriosis specialists. If you are already under the care of a specialist, your Abby Health GP can work alongside that team to manage the day-to-day aspects of your condition, including medication monitoring, pain management, and mental health support.
Continuity of care is central to how Abby Health operates. Our data shows that three in four patients see the same clinician again, which means the GP who understands your endometriosis history is the same GP who manages your ongoing care. For a chronic condition, this is not a convenience. It is a clinical necessity.
Consultations are bulk billed for eligible patients, which means there may be no out-of-pocket cost for your appointment. Cost should never be the reason someone delays getting help for pain that is affecting their quality of life.
If you are ready to talk to a GP about your symptoms, you can book a consultation through our Women's Health clinic today. You do not need a referral. You just need to show up. And if you are looking for information about related conditions, our guide on PCOS: symptoms, diagnosis, and treatment options online covers another common condition that affects many Australian women and can be assessed through the same care pathway.
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