For a lot of patients, the pain of endometriosis is so severe it affects every part of their life, an Auckland gynaecologist says. Photo: 123rf.com
An Auckland gynaecologist says New Zealand urgently needs to overhaul how it diagnoses and treats a debilitating condition that affects at least one in ten Kiwi women, but often goes undetected or dismissed.
Dr Michael Wynn-Williams told Saturday Morning's Susie Ferguson that when it comes to endometriosis, New Zealand's healthcare system is "standing still" - especially when compared to the progress made across the Tasman.
He describes endometriosis as a complex, chronic inflammatory condition caused when tissue similar to the lining of the uterus grows outside the uterus.
It can be superficial or deeply embedded, affecting the ovaries, pelvis, and, in some cases, even the lungs. Symptoms can vary widely between patients, often making the diagnosis difficult.
But one symptom is almost universal.
"For a lot of patients, the pain is so severe it affects every part of their life - their work, relationships, fertility, and mental health."
This pain typically intensifies during menstruation, but despite its severity, it is often normalised, ignored, or dismissed.
"Young people who begin menstruating and experience pain - you can imagine the effect that has on them. The distress comes from not being able to go to school... you're worried about your exams... your future - your fertility."
And unless treated, the condition often gets worse over time.
"Essentially, it's like a volume dial for your pain, that gets dialled up, and it just gets gradually, gradually dials up."
Despite the condition's prevalence, research shows it takes an average of 8-10 years to be diagnosed.
He said this delay is part of a wider systemic failure - one shaped by underfunding, outdated clinical pathways, and what he calls the "gender pain gap."
"Women's pain is poorly understood and mistreated, particularly with a condition like endometriosis, which is invisible."
New Zealand's "postcode lottery" health system is also a factor.
"If you live in a major centre like Auckland, you might get to a specialist - but if you're in New Plymouth right now, you're going to really struggle."
"We need to take action."
But change is possible, he said, Australia's 2018 National Action Plan for Endometriosis National Action Plan for Endometriosis led to a sweeping roll-out of community education programmes, research investment, and GP-led pelvic pain clinics.
"Things changed... massively. We need political buy-in, to instigate a national action plan in New Zealand to really do the same sort of things."
One of the experts behind that plan, Professor Louise Hull from the University of Adelaide, is now helping develop AI tools that could transform how endometriosis is diagnosed.
By training algorithms on thousands of pelvic MRIs and ultrasounds, Hull's team is developing systems that can assist radiologists to spot early signs of the disease.
"One of the main issues is... for MRI experts, it takes them about two years to get very good at reporting.
"So what AI can do is it can use the skills from these experts to look at scans and after a while, it learns and learns how they read the reports and it can build algorithms... to reduce the learning curve.
"And they can circle areas of interest. It can make predictions.
"Radiologists get tired, sonographers may miss something, and the AI can kind of compensate for that to some extent."
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