Ultrasound for Endo? It’s About Bloody Time
New Aussie guidelines push for faster endometriosis diagnosis using ultrasound — ending the long wait for surgery. Finally, patients might get the treatment they need without being sliced open first.
Endo Gets an Upgrade: Ultrasound Now Frontline in New Diagnosis Guidelines
In news that’s music to the ears of millions with uteruses—and possibly a few confused blokes with endo too—the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) has updated its guidelines for endometriosis.
The big change? Ultrasounds are now being recommended as a first-line diagnostic tool. That means no more playing surgical roulette just to get a name for the pain in your pelvis.
Endo Explained – In Plain Aussie
| What It Is | When womb-like cells decide to set up camp in places they don’t belong (like your bowels or bladder). |
|---|---|
| Who It Affects | 1 in 9 Aussie women and folks with uteruses. Even a few unlucky men, believe it or not. |
| Symptoms | Painful periods, infertility, fatigue, gut dramas, and a general feeling of being gaslit by your own body. |
| Diagnosis (Old Way) | Surgery — laparoscopy and tissue samples. Slow, invasive, and waitlisted for eternity. |
| Diagnosis (New Way) | Start with transvaginal ultrasound. If that’s not suitable, try an MRI. Faster, non-invasive, and covered by Medicare come November. |
What’s New in the 2024 “Living” Guidelines?
- Ultrasound First: Transvaginal ultrasound should now be the first tool doctors use — saving patients from going under the knife just to get a diagnosis.
- New Medicare Item (Nov 2024): Endo-specific scans will now be bulk-billed. Finally, something from Canberra that won’t cost us a kidney.
- Parallel Treatment Approach: Patients can start hormonal therapy or pain management while waiting for scans. Revolutionary, right?
- More Than Meds: New recs include physiotherapy and psychological support for managing chronic pelvic pain. Pain is pain — whether it’s physical or mental.
- Cancer Myths Busted: Yes, there’s a slightly higher risk of ovarian and endometrial cancer — but it’s “jolly small” according to Dr Marilla Druitt. (Love the candour.)
Controversies & Criticism
- Still No Public Consult: Peak bodies like the Australian Coalition for Endometriosis (ACE) say they weren’t given enough time for public input on the draft — despite multiple requests.
- Pregnancy Myth Lingers: The guidelines still don’t explicitly say that pregnancy is not a cure, which continues to drive frustrated endo warriors up the uterine wall.
“We are disappointed that the 2025 Guidelines still fail to state that pregnancy is not a cure or treatment for endo. This harmful myth continues to be perpetuated.”
— EndoActive founders, Syl and Lesley Freedman
Voices From the Frontlines
- Dr Marilla Druitt (RANZCOG): “It’s about reducing the delay. We want to treat and investigate at the same time.”
- Prof Danielle Mazza (Monash Uni): Called the new GP toolkit a “gamechanger” for first-line care.
- Jess Taylor (ACE Chair): Says living guidelines are crucial but is disappointed in the closed-door process.
- Alexis Wolfe (Patient Advocate): Says the new resources will help patients advocate for themselves better.
Why It Matters
Delays in diagnosis average 6.5 years in Australia — which is six years too long when your uterus feels like it’s being used as a chew toy by Satan.
Thanks to this update, we might finally see a future where people aren’t told their pain is “just bad period cramps” and instead get timely, evidence-based care.
