Endometriosis is far more common than most people realise, and for many women, it’s an exhausting and often invisible struggle. In Australia, around 1 in 7 women are living with endometriosis, yet the symptoms can look different for everyone.
This is one of the big reasons so many women spend years searching for answers, trying to make sense of pain, fatigue, heavy periods, or gut symptoms that don’t seem to add up. With stories of long diagnostic delays and mixed-quality information online, it’s no surprise that many people feel unsure about what treatment options actually work, and which ones are myths.(1)
To help patients better understand their treatment options for endometriosis, Dr Kafayat “Kafa” Lee, founder of Arami Women’s Health in Melbourne and a GP with a special interest in women’s health and endometriosis, with formal qualifications in women’s and reproductive health, has partnered with Health Hunter to share a clear, up-to-date, evidence-based overview of endometriosis treatments currently available in Australia.
Below, she explains when each option may be useful, how to build the right multidisciplinary support team, and debunks some of the most common misconceptions that can get in the way of proper care.
What Is Endometriosis?
Endometriosis is a chronic inflammatory condition where tissue similar to the lining of the uterus starts to grow in places it shouldn’t, such as around the ovaries, fallopian tubes, bowel, or pelvic wall. In rarer cases, endometriosis has been found in many other locations outside of the pelvis as well.
These growths can cause pain, heavy periods, digestive symptoms, fatigue, and sometimes fertility challenges. Importantly, the severity of symptoms does not always reflect the extent of disease, which is why many people experience long delays before receiving a diagnosis or appropriate treatment.
Understanding what endometriosis is, and how it behaves, is a key first step toward effective, personalised care.
What is the clinical goal of treatment?
Treatments for endometriosis have three overlapping aims: relieve pain, preserve or support fertility, and improve quality of life and function. Not every option suits every person, choice depends on symptoms, age, fertility goals, previous treatments and personal preference. Modern care emphasises shared decision-making with a specialist clinician and access to complementary support where needed. (2)
Evidence-based medical options
1. First-line medical treatments (primary care and specialists)
For many people, medical therapy is the first step. Common, evidence-based options include:
- Combined oral contraceptives (COCPs): reduce menstrual flow and can lessen cyclical pain.
- Progestins (oral progestogens, depot medroxyprogesterone, levonorgestrel IUD/Mirena): effective for many people in reducing pain and suppressing ectopic tissue activity.
- Analgesics and anti-inflammatories: used for symptom relief as part of a broader plan.
Primary care clinicians can safely start these treatments; however, when symptoms are severe or unresponsive, referral to a women’s health GP or gynaecologist is recommended. Contemporary Australian guidance supports the use of hormonal therapies as early and appropriate options. (3)
2. GnRH antagonists and newer pharmaceutical options
A significant recent advance in endometriosis care has been the availability of oral GnRH antagonists, which suppress ovarian hormone production in a more controlled and reversible way than older injectable therapies.
In Australia, relugolix combined with estradiol and norethisterone acetate (Ryeqo®) is PBS-listed for people with moderate to severe endometriosis-related pain who have not responded adequately to first line hormonal treatments or analgesics.
Specialist Medical Practitioners including GPs with experience in diagnosing and managing endometriosis, can prescribe this medication within PBS criteria, improving timely access for patients.
GnRH antagonists are an important option for persistent or severe symptoms, and while monitoring is required, they represent a more flexible and better-tolerated option than older suppressive therapies.
(Note: Progesterone receptor modulators are not currently available for endometriosis treatment in Australia and are not included in evidence-based care pathways as of now.) Find out more here (4)
3. Alongside these newer options, GnRH agonists (also called analogues) remain available and may be used in selected situations.
These medications are given as injections or a nasal spray and work by more fully suppressing ovarian hormone production. In Australia, GnRH agonists are PBS-listed for short-term use, typically when other treatments have been unsuccessful or are not suitable. Because they can cause menopausal-type side effects, they are generally prescribed for limited periods and often alongside add-back hormone therapy to improve tolerability and protect bone health.
While both GnRH antagonists and agonists can be effective for symptom control, the choice between them depends on individual symptoms, treatment history, side-effect tolerance and personal preferences. A GP or treating clinician can help guide this decision as part of a broader, individualised care plan.
4. Hormonal therapies for fertility concerns
If fertility is a priority, medical therapy is tailored carefully. Some hormonal suppressive treatments may need to be paused when attempting pregnancy; fertility-directed interventions such as assisted reproductive technologies (ART) or laparoscopic surgery (for certain lesion types) are considered in partnership with fertility specialists and gynaecologists. National action plans and guidelines emphasise early referral when fertility is a concern. (5)
Surgical treatment: When and what kind?
Recent Australian and international guidance supports imaging (transvaginal ultrasound or pelvic MRI) and medical therapy as first-line in many cases, reserving surgery for targeted indications and performed by experienced teams. (6)
Surgery remains an important treatment for many people with endometriosis, especially where pain is severe, where there are endometriomas (ovarian cysts), or where diagnosis is unclear. The preferred surgical approach for pelvic endometriosis is excisional surgery by a surgeon experienced in endometriosis (removal of lesions and adhesions), rather than simple ablation. Where fertility is a pressing issue, carefully planned surgery can improve outcomes for some patients, but the decision must balance potential benefits with risks such as ovarian reserve reduction.
Non-surgical, non-pharmacological interventions (evidence-based supports)
1. Pelvic physiotherapy and persistent pelvic pain management
Pelvic physiotherapy, targeting pelvic floor muscles, myofascial trigger points and movement, is now widely recognised as a core component of care for chronic pelvic pain and endometriosis-related pain. Specialist pelvic physiotherapists use manual therapy, education and graded exercise to reduce pain and improve function. Australian professional bodies and pain services increasingly emphasise nervous-system-informed approaches. (7)
2. Pain medicine and chronic pain programs
When pain becomes persistent (lasting >3 months), central sensitisation can develop. Pain medicine specialists and multidisciplinary chronic pain programs can offer strategies such as neuropathic pain medications, nerve blocks, and graded rehabilitation to reduce disability. (8)
3. Psychological therapies and lifestyle supports
Cognitive behavioural therapy (CBT), acceptance and commitment therapy (ACT), sleep optimisation, stress-reduction techniques and paced activity have evidence for improving quality of life and coping. Dietitians, exercise physiologists and allied health professionals also play roles in symptom management and general wellbeing. Australian guidelines and the National Action Plan encourage integrated access to these services. (9)
The importance of multidisciplinary care
Endometriosis is not purely a gynaecological problem but for many it is a complex biopsychosocial condition. Best practice in Australia increasingly highlights multidisciplinary teams that may include: women’s health GPs, gynaecologists with endometriosis expertise, pelvic physiotherapists, pain physicians, psychologists, fertility specialists, dietitians and specialist nurses. This model may improve diagnostic accuracy, reduces delays, addresses multiple drivers of pain and dysfunction, and supports long-term wellbeing. The updated living guidance and national initiatives reflect this shift towards coordinated care. (10)
Mythbusting: common false beliefs and the evidence
Myth 1: New treatments for endometriosis are just the same as old hormonal injections
Fact:
This is a common misunderstanding. In the past, many people with endometriosis were prescribed GnRH agonist injections such as Zoladex (goserelin) or Lucrin (leuprorelin). These drugs suppress the production of oestrogen, inducing a temporary menopausal state to reduce endometrial lesion growth. While they could relieve symptoms for some, they were often associated with difficult side effects like hot flushes, bone loss, mood changes, and vaginal dryness, leading many to discontinue treatment.
Today's newer hormonal therapies like GnRH antagonists, work in a much more targeted way. They don’t completely shut down oestrogen but aim to balance hormonal signalling, easing pain and inflammation while maintaining more normal hormonal rhythms. While no treatment is perfect, it’s important to recognise that these modern options are quite different from the older injection-based suppressive therapies.
Myth 2: “Pregnancy will cure endometriosis.”
Fact:
Pregnancy may temporarily reduce symptoms for some people, but it is not a cure. Symptoms can frequently return after pregnancy. Treatment should not rely on pregnancy as a therapeutic strategy. (11)
Myth 3: “Hysterectomy cures endometriosis.”
Fact:
Removing the uterus (hysterectomy) can relieve menstrual pain but does not reliably cure endometriosis, because lesions outside the uterus can persist. Hysterectomy is a major operation and is not a guaranteed solution for pain or recurrence. (12)
Myth 4: “Severe pain always means severe disease (and vice versa).”
Fact:
Pain severity does not always correlate with lesion extent. Some people with extensive disease have little pain; others with minimal visible lesions have debilitating pain. Clinical assessment must focus on the person’s symptoms and function, not lesion count alone. (13)
Myth 5: “Hormones are unnatural and harmful”
Fact:
Hormones are not “unnatural”. They are chemical messengers that drive nearly every function in the body, from energy and mood to fertility and immune balance. What matters is how they’re used and balanced. When prescribed appropriately, hormonal therapies can reduce inflammation, manage pain, and slow endometrial tissue growth. The goal is not to “replace nature” but to help restore hormonal balance in a system that’s become dysregulated by chronic inflammation and immune dysfunction.
Many people also find success combining natural hormone support, such as nutrition, herbal medicine, and stress regulation, with evidence-based medical treatments. This integrative approach can minimise side effects and support the body’s natural rhythms while easing symptoms.
Myth 6: “Diet alone will fix endometriosis.”
Fact:
Nutrition and lifestyle can significantly help symptoms and wellbeing, but diet alone does not cure the disease. Dietary changes are best used as part of a broader, evidence-based management plan. (14)
Practical steps if you suspect endometriosis
- See your GP: describe clearly the pattern, severity and impact of symptoms (don’t minimise them). Early primary care action can speed access to effective treatments. (15)
- Ask about non-invasive imaging: updated Australian guidance supports transvaginal ultrasound or MRI as part of diagnosis for many people, which can reduce time to treatment. (16)
- Discuss medical therapy options: contraception, progestins, or contraception, progestins, or GnRH antagonists may be appropriate. Consider referral to a women’s health GP or gynaecologist for complex or refractory symptoms. (17)
- Check out all the support available on Qendo: https://www.qendo.org.au/
- Build a multidisciplinary team around you: pelvic physio, pain services, mental health support and allied health are proven partners in long-term management. (australian.physio)
Final note: Personalised care, not one-size-fits-all
Endometriosis care is personal.
Advances in medical therapy (including subsidised options in Australia), better imaging, and growing recognition of multidisciplinary approaches mean better choices and better outcomes are possible today than ever before.
The most important thing is to be heard by health professionals, be educated properly on treatment options and understand mis-information, get timely assessment, and be offered a treatment plan that fits your goals. Whether that’s symptom relief, fertility planning, or long-term wellbeing, there are now further personalised options available.
Dr Kafayat Lee
Dr Kafayat (Kafa) Lee (DRCOG; DFSRH; FRACGP) Specialist Women’s Health GP, Founder of Arami Women’s Health, Board, Certified Lifestyle Medicine Physician (ASLM and IBLM), Menopause Society Certified Practitioner.
Dr Kafa Lee is a Melbourne-based Specialist Women’s Health GP and the founder of Arami Women’s Health. She has a special interest in Sexual and Reproductive health through various life stages and holds formal qualifications in women’s and reproductive health.
Dr Lee’s clinical work focuses on providing evidence-based, patient-centred care for women experiencing endometriosis, chronic pelvic pain, menstrual disorders and hormonal concerns. She is known for her holistic yet medically grounded approach, emphasising early intervention, shared decision-making and multidisciplinary care to improve long-term outcomes and quality of life.
In addition to her clinical practice, Dr Lee is a trusted voice in women’s health education and advocacy. She regularly contributes expert commentary and supports improved awareness and access to care through public education.
For more information, or to book an appointment visit Arami Women's Health
References
- Australian Institute of Health and Welfare — Endometriosis in Australia 2023 (summary & stats). https://www.aihw.gov.au/reports/chronic-disease/endometriosis-in-australia-2023/contents/summary. (AIHW)
- Endometriosis Australia — Understanding endometriosis and mythbusting resources. https://endometriosisaustralia.org/understanding-endometriosis/ and https://endometriosisaustralia.org/endo-myth-busting/. (Endometriosis Australia)
- Australian Endometriosis Guideline (clinical guideline PDF). https://www.acn.edu.au/wp-content/uploads/australian-endometriosis-guideline.pdf. (ACN)
- Department of Health — National Action Plan for Endometriosis and related information. https://www.health.gov.au/sites/default/files/national-action-plan-for-endometriosis.pdf and https://www.health.gov.au/topics/chronic-conditions/what-were-doing-about-chronic-conditions/what-were-doing-about-endometriosis. (Health, Disability and Ageing)
- PBS listing — Relugolix + estradiol + norethisterone acetate (Ryeqo®) listing details. https://www.pbs.gov.au/medicine/item/14795Q. (Pharmaceutical Benefits Scheme)
- RANZCOG / news coverage — updates on diagnostic imaging and living guidance (examples). (See: news reporting summarising RANZCOG updates) https://www.theguardian.com/australia-news/2025/may/10/ultrasound-diagnosis-could-lead-to-faster-treatment-of-endometriosis. (The Guardian)
- Royal Australian College of General Practitioners (RACGP) — review on endometriosis diagnosis and management. https://www1.racgp.org.au/ajgp/2024/january-february/endometriosis. (RACGP)
- Australian Physiotherapy Association (Pelvic health & persistent pelvic pain). https://australian.physio/inmotion/persistent-pelvic-pain-and-endometriosis. (australian.physio)
Helpful links:
Frequently Asked Questions
1. What are the early symptoms of endometriosis? Painful periods, chronic pelvic pain, pain during intercourse, heavy bleeding, and fatigue are common early signs often mistaken for normal menstrual discomfort.
2. Can diet alone treat endometriosis?
Diet helps manage symptoms by reducing inflammation but works best alongside medical treatment and lifestyle changes for effective symptom control.
3. How is endometriosis diagnosed?
Diagnosis involves symptom review, pelvic exams, imaging, and laparoscopy, which confirms presence of endometrial tissue outside the uterus.
4. What conventional treatments are available for endometriosis?
Hormonal therapies, pain relief, and surgery are common options depending on symptom severity and response to medication.
5. Are natural treatments safe alongside conventional medicine?
Natural therapies can be safe but should be discussed with healthcare providers to avoid interactions and ensure coordinated care.
6. Is surgery always necessary for managing endometriosis?
Surgery is for severe or unresponsive cases; many manage symptoms well with medication and integrative approaches without surgery.
The information provided in this article is for general educational purposes only and is not intended as medical advice. It does not replace consultation with a qualified healthcare professional. Individual health needs vary, and readers should seek personalised medical advice from their doctor or other registered health practitioner before making any changes to their healthcare, treatment, diet or supplementation. If you are experiencing a medical emergency, please call 000 or seek immediate medical attention. This review of treatments has been financially supported by Gedeon Richter but has had no influence on the final content and/or author’s comments. Full editorial independence is with Health Hunter.
