Consultation: Endometriosis Guideline

Endometriosis is a chronic, debilitating condition.  It is estimated that more than 830,000 Australian women and girls are affected by endometriosis. One in nine women had clinically confirmed or suspected endometriosis by the age of 44 years, with most diagnosed during their early thirties.  

Under the national blueprint, National Action Plan for Endometriosis (2018), the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) has administered the development of a draft Australian Clinical Practice Guideline for the Diagnosis and Management of Endometriosis (2020) (Guideline).

The Guideline has been developed by a multidisciplinary expert working group with members from across Australia with an interest in endometriosis and adenomyosis, including obstetricians and gynaecologists, pain medicine specialists, fertility specialists, general practitioners, physiotherapists, complementary medicine experts, nurse practitioners and consumer representatives.

Importantly, the Guideline provides evidence-based recommendations to support the diagnosis and treatment of endometriosis and adenomyosis – a related condition that coexists with endometriosis in some people. It is developed for use within the Australian context, to contribute to greater consistency in clinical practice and improved outcomes for Australians living with these chronic conditions. 

The Guideline was developed with funding support from the Australian Government Department of Health, and administered by RANZCOG.


Public consultation

You are invited to provide feedback on the draft Guideline. Your contribution will help to ensure delivery of a tailored and usable guideline across Australian clinical practice.

Public consultation for this guideline will be open for a six-week period, between 12 November – 24 December 2020, inclusive.


How to provide feedback

​Online survey

Consultation is an integral part of the Guideline development process, and we ask that you focus on the content and implementation issues for the Guideline, by completing the online survey:

> Start the survey

You will require approximately 30 minutes to complete the survey. The survey contains maximum word limits. It is possible to save incomplete surveys and return to the survey at a later time during the consultation period only.

A link to corresponding sections of the Guideline are provided within the survey.

Written submissions

You can submit feedback by letter, email or using the questionnaire provided.

Email submissions to [email protected] by 24 December 2020.

​Post written letters to:
College House
Attn: Jinty Wilson
254 Albert Street
East Melbourne, VIC 3002

Please refer to the full Technical Report for evidence tables, with summaries of specific studies.

For further information, please contact: [email protected] during the consultation period. Unfortunately, extensions to the current consultation dates cannot be accommodated.


Supporting Documents


Frequently Asked Questions

What is endometriosis?

Endometriosis is a common inflammatory condition where cells similar to the endometrium (the mucous membrane lining the uterus) grow outside of the uterus. Most frequently endometriosis occurs in the pelvis, and occasionally in tissues and organs outside the pelvis.

Who is affected by endometriosis?

Endometriosis is thought to affect more than 830,000 women and girls across Australia. The condition negatively impacts the quality of life of one in every nine Australian women aged 40–44 years.

What are the symptoms of endometriosis?

The common symptoms of endometriosis include various pains, fatigue and impairment of fertility. The symptoms of endometriosis are highly variable – some people experience minor symptoms, and others having recurring symptoms that substantially impact their quality of life.

What is adenomyosis?

Adenomyosis is a condition that can coexist with endometriosis in some people. Adenomyosis occurs when endometrial-like cells grow within the uterus, in the uterine wall.  

How was the draft guideline developed?

The draft Australian guideline is adapted from the UK’s clinical guideline, Endometriosis: diagnosis and management (NG73) published by the National Institute of Health and Care Excellence (NICE) in 2017. The Australian guideline has a wider scope, covering populations specific to Australia and new topics, including adenomyosis.

The Australian guideline recommendations are developed using a hybrid approach, whereby some recommendations were adopted or adapted from the NICE guideline, and others were developed de novo, based on new evidence reviews. Details of the evidence reviews are available in the Technical Report.

What’s new about this Guideline?

This is a new national clinical practice guideline for use by people who may be experiencing endometriosis, health professionals, policy makers and researchers. It is developed through funding from the Australian Government and administered by The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG).

New aspects of the draft Australian guideline include: 

  • Population groups, including: postmenopausal people, pregnant people, non-binary people, Aboriginal and Torres Strait Islander people, and people with subfertility or deferred fertility due to medical therapy.
  • Interventions, including the role of clinical examination and imaging (CT) in diagnosis; use of novel analgesics (medicinal cannabis) in pain management; alternative therapies (Tai chi, ayurvedic therapies, aromatherapy); diets (FODMAP) and dietary supplements.
  • Stages of care, including: Referral to secondary care, Interdisciplinary care, follow—up and secondary prevention of endometriosis.
  • Surgical interventions, including: a comparison hysterectomy vs no hysterectomy.

In addition, the Australian guideline also stipulates risk of cancer as an entirely new question contextualised to Australia.

Why is this Guideline important?

This Guideline seeks to provide up to date evidence-informed guidance to support the highest quality of consistent care for people with endometriosis in a variety of care settings across Australia.

It is hoped that this Guideline will contribute to improved care and greater consistency in clinical practice for people with endometriosis and adenomyosis across Australia.

From a policy and advocacy perspective, the draft Australian guideline is the first  national guideline to be created under the blueprint of National Action Plan for Endometriosis (2018)

As the lead standards body in women’s health across Australia and New Zealand, RANZCOG is proud and privileged to be pioneering this important project in high-quality, evidence-based guidance available across Australia.

Who is this guideline for?

The target audience for this Guideline are healthcare professionals working with people with suspected or confirmed endometriosis and/or adenomyosis in Australia. The Guideline is also intended for people with endometriosis, their families and carers and the public.

Where can I find more information?




The purpose for dissemination of these draft guidelines is for public consultation to provide consumers with opportunities to share their views about women’s health issues concerning Endometriosis and related conditions. All feedback is valuable, however not all activities or feedback will translate into changes to these draft guidelines. If you submit feedback, please note that all submissions will be treated as public unless the author clearly indicates to the contrary.

The draft guidelines are provided solely for consultation purposes with the aim to improve their quality, legitimacy and acceptability to end users and the public. This information is intended to provide general advice to practitioners and should not be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of any patient. It is the responsibility of each practitioner to have regard to the particular circumstances of each case. Clinical management should be responsive to the needs of the individual patient and the particular circumstances of each case.

Quality of information
The information available in the draft Australian Endometriosis Guideline Materials are intended as a guide and provided for information purposes only. The information is based on Australian context using the best information and evidence available at the time of preparation. Whilst the Royal Australian and New Zealand Collage of Obstetricians and Gynaecologists (RANZCOG) endeavours to ensure that information is accurate and current at the time of preparation, it takes no responsibility for matters arising from changed circumstances or information or material that may have become subsequently available. Use of this information is entirely at your own risk and responsibility.

For the avoidance of doubt, the materials were not developed for use by patients, and patients must seek medical advice in relation to any treatment. The material includes the views or recommendations of third parties and does not necessarily reflect the views of RANZCOG or indicate a commitment to a particular course of action.

Third party sites
Any information linked in this draft guideline is provided for the user’s convenience and does not constitute an endorsement or a recommendation or indicate a commitment to a particular course of action of this information, material or content, unless specifically stated otherwise.

RANZCOG disclaims, to the maximum extent permitted by law any responsibility and all liability (including without limitation, liability in negligence) to you or any third party for inaccurate, out of context, incomplete or unavailable information contained on third party website, or for whether the information contained on those websites is suitable for your needs or the needs of any third party for all expenses, losses, damages and costs incurred.

Exclusion of Liability
The College disclaims, to the maximum extent permitted by law, all responsibility and all liability (including without limitation, liability in negligence) to you or any third party for any loss or damage which may result from your or any third party’s use of or reliance of this draft guideline, including the materials within or referred to throughout this document being in any way inaccurate, out of context, incomplete or unavailable for all expenses, losses, damages and costs incurred.

Exclusion of Warranties
To the maximum extent permitted by law RANZCOG makes no representation, endorsement or warranty of any kind, expressed or implied in relation to the materials within or referred to throughout this document being in any way inaccurate, out of context, incomplete or unavailable for all expenses, losses, damages and costs incurred.

These terms and conditions will be constructed according to and are governed by the laws of Victoria, Australia.

Privacy Policy

The College is committed to ensuring the privacy of individuals, in accordance with applicable privacy principles in Australia and New Zealand. The College’s Privacy Policy provides details regarding the information-handling practices and gives guidelines for access to any information retained by the College. For more information please refer to the RANZCOG Privacy Policy


More information

For further information, please contact us during the consultation period.

Email[email protected]

Unfortunately, extensions to the current consultation dates cannot be accommodated.




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