'Think about endometriosis' new recommendations for GPs

Endometrial-like tissue grows outside of the uterus causing painful inflammation, the condition is progressive and currently lacks a medical cure.

The tissue can lead to adhesions between internal organs causing a sharp, stabbing pains as connections are pulled and broken during everyday movement.

University of Melbourne department of obstetrics and gynaecology's Professor Martha Hickey told ACM she urged GPs to check for endometriosis when women present with pain associated with menstruation, intercourse or bowel movements in the report 'Endometriosis - easily missed'.

"The recommendations give GPs some reminders about when and how to think about endometriosis," she said.

Melbourne woman Sarah Geoghegan told ACM she faced difficulty walking and blinding pain during some menstruation cycles due to pelvic inflammation.

Australian society was ready to accept monthly pain for women was normal and that women who complained were "difficult," Ms Geoghegan said.

Ms Geoghegan advocated for a gynaecologist referral from five separate GPs and is now struggling to access critical keyhole surgery after her scheduled elective procedure was cancelled during Melbourne's COVID-19 lockdowns.

The laparoscopic keyhole surgery is useful for identifying and removing endometrial tissue, but cannot stop the endometrial-like tissue regrowing.

Hormone suppressing contraception, like the Mirena, can be used in an attempt to stop endometrial-like tissue from forming but this treatment is not appropriate for people trying to fall pregnant.

Laparoscopic keyhole surgery is healthcare's current best treatment for endometriosis, but is a less-than perfect solution, Professor Hickey said.

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"The evidence that surgery permanently helps is not strong, for some women it doesn't help at all," Professor Hickey said.

"It's complicated surgery and has the potential to do real harm."

"One of the characteristics of endometriosis is it looks like other things, it usually doesn't have obvious indicators," she said.

The report 'Endometriosis - easily missed' urges GPs to keep the condition top of mind, considering diagnostic delays can lead to considerable "suffering, distress and economic hardship."