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Endometriosis — recognition, first-line management, referral

A detailed Australian summary of endometriosis — recognition, first-line management, referral, with source-attributed priorities, a practical workflow, safety escalation and state or territory implementation boundaries.

JurisdictionAustralia
Source check2026-08-20
Clinical reviewiatroX editorial team · Clinical editorial review · reviewed 2026-08-20 · due 2027-08-20
AudienceHealthcare professionals practising in Australia
This is an iatroX educational summary of named Australia sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. Apply current TGA product information, PBS restrictions, state or territory law, local referral criteria, formulary and antimicrobial policy. A national recommendation does not create uniform service access.

Scope

Suspect endometriosis with cyclical pelvic pain, dysmenorrhoea, deep dyspareunia, dyschezia, urinary symptoms, infertility or persistent non-cyclical pelvic pain. A normal pelvic examination or ultrasound does not exclude superficial disease; use imaging to map endometrioma and deep disease when indicated. This summary is limited to the population, decisions and escalation boundaries stated in the named source.
sources for this section:Australian endometriosis guideline

The Bottom Line

  • Suspect endometriosis with cyclical pelvic pain, dysmenorrhoea, deep dyspareunia, dyschezia, urinary symptoms, infertility or persistent non-cyclical pelvic pain.
  • A normal pelvic examination or ultrasound does not exclude superficial disease; use imaging to map endometrioma and deep disease when indicated.
  • Assess bowel and bladder cyclic symptoms and map deep dyspareunia because organ-specific disease affects imaging and referral.
  • Offer analgesic and hormonal symptom management without requiring surgery first when pregnancy is not desired and no contraindication exists.
sources for this section:Australian endometriosis guideline

Practical clinical workflow

1

Topic-specific assessment action

Suspect endometriosis with cyclical pelvic pain, dysmenorrhoea, deep dyspareunia, dyschezia, urinary symptoms, infertility or persistent non-cyclical pelvic pain.
2

Topic-specific diagnostic action

Offer analgesic and hormonal symptom management without requiring surgery first when pregnancy is not desired and no contraindication exists.
3

Topic-specific management action

Refer for diagnostic uncertainty, fertility goals, endometrioma, deep disease, organ involvement or pain that persists despite an adequate treatment trial.
4

Topic-specific follow-through

Discuss fertility preservation and avoid prolonged suppression when active conception is the person’s immediate goal.
sources for this section:Australian endometriosis guideline

Safety boundaries and escalation

  • Acute severe pain, peritonism, pregnancy possibility, haemodynamic change, urinary obstruction or bowel obstruction requires emergency alternative-diagnosis assessment.
  • Use multidisciplinary pelvic-pain care when central sensitisation, pelvic-floor dysfunction or overlapping bladder and bowel syndromes persist.
sources for this section:Australian endometriosis guideline

Implementation

The named source is national or binational guidance used in Australia, but referral access, public-health directions, formularies and funded services can still differ by state, territory and health service. Check current TGA product information for medicines. Offer culturally safe care and use the NACCHO–RACGP National Guide where Aboriginal and Torres Strait Islander preventive or chronic-care recommendations differ.
sources for this section:Australian endometriosis guideline

Clinical use boundary

This independently written summary is not an official guideline. Check the linked source version, current TGA-approved product information where medicines are involved, and the applicable state, territory and local pathway at the point of care.

sources for this section:Australian endometriosis guideline

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Royal Australian and New Zealand College of Obstetricians and GynaecologistsAustralian Living Evidence Guideline: EndometriosisLiving evidence guideline checked 2026-08-20 · accessed 2026-08-20
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