Concerns are mounting over potential overtreatment of endometriosis, as investigations into medical practitioners rise and the number of surgeries performed for the condition nearly doubles.
The Shifting Landscape of Endometriosis Care
For decades, endometriosis – a condition affecting approximately 10% of women of reproductive age – was often underdiagnosed and dismissed. Now, increased awareness is leading to a surge in diagnoses and, surgical interventions.
Between 2016 and 2023, the number of endometriosis surgeries almost doubled, according to government data. This rise coincides with approximately 225 complaints received by the Australian Health Practitioner Regulation Agency (AHPRA) regarding endometriosis treatment between 2021-22 and 2023-24.
Concerns Over Unnecessary Procedures
Medical leaders are warning that the increased attention on endometriosis may be driving a trend towards surgery that isn’t always supported by robust evidence. One Melbourne gynaecologist is currently under investigation by AHPRA following allegations of performing unnecessary surgeries, including ovary removal.
The debate centers on whether surgery is always the most appropriate course of action, particularly given that a significant proportion of women with endometriosis experience no symptoms.
The Role of Diagnosis and Emerging Guidelines
Accurate diagnosis remains a challenge. While ultrasound and MRI are recommended by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), some research suggests these imaging techniques aren’t always reliable enough to replace diagnostic surgery.
RANZCOG recently released guidelines emphasizing that surgery should be reserved for specific cases, such as endometriotic cysts that cause pain by rupturing or twisting.
Future Trends in Endometriosis Management
The current shift in focus suggests several potential future trends in endometriosis care:
- Emphasis on Non-Surgical Treatments: Increased focus on pain management strategies, hormonal therapies, and physiotherapy to address symptoms without resorting to surgery.
- Refined Diagnostic Criteria: Development of more accurate and non-invasive diagnostic tools to reduce the need for exploratory surgery.
- Personalized Treatment Plans: Tailoring treatment approaches based on individual patient symptoms, disease severity, and preferences.
- Multidisciplinary Care: Greater collaboration between gynaecologists, pain specialists, physiotherapists, and other healthcare professionals to provide comprehensive care.
The establishment of endometriosis and pelvic pain clinics across Australia, with a government investment of $127 million, signals a commitment to improving diagnosis and care.
As understanding of endometriosis evolves, a more cautious and individualized approach to treatment is likely to emerge, prioritizing patient well-being and minimizing unnecessary interventions.
Henrietta Cook is a senior reporter covering health for The Age. Henrietta joined The Age in 2012 and has previously covered state politics, education and consumer affairs. Connect via X , Facebook or email . 
Liam Mannix is The Age and The Sydney Morning Herald’s national science reporter. Connect via X or email . 