New hope for pelvic pain management

In Australia, around one in seven women has clinically confirmed or suspected endometriosis by the age of 44. That’s 14% of all women.
 
From next week, a pilot program is being rolled out around the country that is hoped to better equip GPs to manage and treat women with this often-painful condition.
 
The Endometriosis Management Plan (EMP) will be trialled in eight medical centres nationally, following its development in a partnership between the RACGP and Monash University’s SPHERE Centre of Research Excellence.
 
The online EMP has been developed with primary care settings in mind, being the usual first port of call for people experiencing symptoms associated with endometriosis.
 
It provides clinicians and patients with evidence-based recommendations and resources to better manage endometriosis and chronic pelvic pain, by helping to identify symptoms and plan patient goals. 
 
The plan also includes a toolkit and video to assist clinicians in their practice, and an information resource for patients. 
 
SPHERE Director and Head of the Monash University Department of General Practice, Professor Danielle Mazza, said the EMP encourages GPs to use chronic disease management planning for the treatment of endometriosis.
 
‘Traditionally, when we’ve thought about a chronic disease management plan, we’ve thought about it for older people with diabetes or heart disease or dementia,’ she told newsGP.
 
‘We haven’t really thought about using one for the management of endometriosis, which often requires allied health input to make the care more holistic and more effective.’
 
The EMP trial follows last month’s release of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists’ new National Endometriosis Guidelines.
 
‘We’ve been able to work closely with the College of Obstetrics and Gynaecology to integrate the recommendations in the new guideline into this management plan, so that it really is also pushing GPs towards more evidence-based diagnostic and management,’ Professor Mazza said.
 
Chronic pelvic pain is a frequent symptom of endometriosis for the thousands of women living with the condition. But even for those without endometriosis, its impact still comes at a cost.
 
The total economic burden of endometriosis and chronic pelvic pain  in Australia is estimated at between $7.4 billion and $9.7 billion annually.
 
Professor Mazza says GPs ‘can do a lot early on’ to help women manage the condition, with one of the new guidelines being that symptom management can be commenced prior to a laparoscopy.
 
‘Hormonal treatments are the first line option,’ she said. ‘GPs can readily implement those, so they have the ability to intervene early.
 
‘GPs and other clinicians can do a great deal more to support the management of endometriosis and pelvic pain within primary care settings, and to assist women to better understand and manage the condition.’
 
The EMP is among a suite of initiatives funded by the Australian Government’s National Action Plan for Endometriosis.
 
Since the action plan’s launch in 2018, the Government has committed more than $87 million to endometriosis research, awareness and education, and clinical management and care.
 
Of that, it has invested $4.7 million into the EMP’s development and implementation.
 
Following the evaluation of its trial, the EMP will be rolled out to all primary care settings in mid-2026.
 
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