December 2025
Endometriosis diagnoses on the rise, but delays persist
By Sasha Ellery BM BCh
The proportion of women diagnosed with endometriosis attending Australian general practice has nearly doubled over the past decade, finds a new analysis of national general practice data. Despite this increase, many women continue to wait years between first experiencing symptoms and receiving a formal diagnosis, highlighting ongoing challenges in primary care management of this chronic condition.
The retrospective cohort study, published in The Medical Journal of Australia, analysed data from more than 1.7 million women aged 14 to 49 years who were active Australian general practice patients between 2011 and 2021. During this time, first documented endometriosis diagnoses were recorded for 19,786 women. The annual age-standardised prevalence rose from 1.78 per 100 women in 2011 to 2.86 per 100 in 2021, with the greatest relative increase among women aged 20 to 24 years, whose diagnoses more than doubled.
Speaking to Medicine Today, Dr Sharinne Crawford, coauthor of the study and a Senior Research Fellow at Monash University, Melbourne, said the increase most likely reflected shifts in awareness and practice. ‘Community awareness of endometriosis has grown significantly in recent years, driven by strong advocacy from peak bodies and initiatives like the National Action Plan on Endometriosis. Greater awareness of the condition encourages people with endometriosis-related symptoms to seek help from their GP.’
Most women had at least one symptom documented before diagnosis, including pelvic pain (40.8% of women) and dysmenorrhoea (22.1%). The median time from first symptom to diagnosis was 2.5 years, although one in four women waited five years or longer. Pelvic ultrasound was the most frequently requested imaging modality, with requests increasing from 18.9% of women diagnosed in 2011 to 48.6% in 2021.
Women often presented with a wide range of symptoms, including nonspecific ones such as fatigue or bowel changes, which were associated with diagnostic delays. Coexisting conditions such as anxiety, depression and asthma added complexity to management.
‘[GPs have] reported a lack of confidence in diagnosing and managing endometriosis, citing reasons such as limited knowledge about the condition. Symptoms can therefore be overlooked or mistaken as relating to other conditions… and this could contribute to an increase in the time to diagnosis,’ Dr Crawford explained.
She added that these delays could significantly impact the wellbeing of the patient. ‘For some women, symptoms are debilitating, and not only impact their physical health, but also their mental health, social lives, fertility, intimacy, work and school attendance.’
Although the prescription of hormonal treatments generally followed guidelines, the authors found low use of long-acting reversible contraceptives, an effective treatment option, and a relatively high reliance on opioids.
Dr Crawford said there was scope to strengthen primary care support. ‘In Australia, clinical guidelines for endometriosis have recently been updated [https://ranzcog.edu.au/wp-content/uploads/Endometriosis-Clinical-Practice-Guideline.pdf] and provide some guidance for primary care clinicians.’ She noted that the Endometriosis Management Plan, developed by Monash University and funded by the Australian Government Department of Health, Disability and Ageing, would be rolled out nationally in mid-2026 and there were various online resources available on endometriosis for clinicians, such as the EndoZone and Jean Hailes for Women’s Health websites.
‘Our team is also providing a series of webinars next year in collaboration with the RACGP … to support GPs across Australia,’ Dr Crawford added.