Health NZ to Implement RANZCOG’s Australian Living Evidence Guideline: Endometriosis for use in Aotearoa

The RANZCOG Australian Living Evidence Guideline: Endometriosis

Originally published in May 2025, the guideline was funded by the Australian Government and living evidence has been updated periodically to reflect the most recent scientific evidence for endometriosis and adenomyosis care in Australia.

This pivotal resource provides a broad range of recommendations, seeking to improve awareness, detection, and management of these conditions which impact so many women globally.

Key aspects of the guideline include:

A focus on primary care, aimed at improving access for GPs to support early management of suspected endometriosis and/or adenomyosis through first-line hormonal treatment while diagnostic processes are underway.

Emphasis on non-invasive diagnostic techniques where possible, such as transvaginal ultrasound and magnetic resonance imaging (MRI).

Specific recommendations for adolescents.

Highlighting the importance of multidisciplinary care, including physiotherapists, psychologists, pain specialists, and fertility specialists, and promoting shared decision-making.

Adapting and implementing the guideline to the Aotearoa New Zealand context

Approximately one in ten women and girls in Aotearoa New Zealand are affected by endometriosis.¹ Aotearoa New Zealand currently follows the New Zealand Government’s Diagnosis and Management of Endometriosis in New Zealand guideline, released in 2020. The implementation of RANZCOG’s guideline will ensure that the most recent and high-grade scientific evidence underpinning endometriosis and adenomyosis care is used, whilst additional Aotearoa New Zealand context will ensure it reflects the specific health systems and demographic needs of women and girls in Aotearoa.

Diagnosis of endometriosis in Aotearoa is currently taking a median of 10 years – likely a result of a range of factors including access to specialist care, surgery wait times, barriers to ultrasound and MRI access, and lack of awareness of the condition. Through these guidelines, GPs and primary care practitioners will be empowered to make clinical diagnoses and begin first-line treatment, with the goal to significantly improve the timeline from suspected diagnoses to symptom management. Health New Zealand has proposed that implementation of the guideline be supported by primary care education initiatives, including webinars and GP education resources.

Women in Aotearoa wait a median of a decade for endometriosis diagnosis – this is a statistic we cannot accept. The adaptation and implementation of these guidelines is an important step to improving awareness and access to evidence-based care for women and girls impacted by this often-debilitating condition.

– Professor Cindy Farquhar, RANZCOG Dean of Research and Policy

Health New Zealand expect to publish the guidelines in mid-2027, following internal clinical assessment by their National Clinical Governance Group. RANZCOG looks forward to supporting Health New Zealand and Endometriosis New Zealand with the review and implementation of the guideline into the Aotearoa context, to continue to improve education, access, and care for women.