The Endometriosis Management Plan

Endometriosis is a chronic condition defined by the presence of endometrial-like tissue outside the uterus. It affects approximately 10% of people of reproductive age worldwide, about 50% of people presenting with infertility and 24-40% of those with chronic pelvic pain. In Australia, one in seven (14%) people are diagnosed with endometriosis by the age of 44-49 years. The total economic burden of endometriosis and chronic pelvic pain per year in Australia is estimated at $6.50 billion (Intl). Although the cause of endometriosis remains uncertain, the condition has critical implications for people's quality of life.

The Endometriosis Management Plan project was conducted by SPHERE CRE in collaboration with the RACGP. The Endometriosis Management Plan is available to all practicing GPs, and people with endometriosis and chronic pelvic pain in Australia. 

The Endometriosis Management Plan is available now! 

Below are some frequently asked questions about the plan.

1. What is endometriosis and how is it diagnosed?

In women with endometriosis, endometrium-like tissue (usually found only in the lining of the uterus) grows outside the uterus, mainly on pelvic organs and tissues, causing inflammation and scar tissue formation. Endometriosis may be diagnosed using imaging techniques such as an ultrasound, however surgery (e.g., laparoscopy) may also be necessary to confirm the diagnosis. GPs should be making a preliminary diagnosis of endometriosis and initiate treatment early to improve patient symptoms but they often lack the confidence to do so.

2. How is it treated? Is there a cure?

There is currently no known cure, but endometriosis symptoms can be treated with medication, evidence-based non-pharmaceutical interventions (e.g., pelvic physiotherapy, counselling, diet) or, in some women, surgery, depending on the women’s symptoms and goals.

3. What is the difference between endometriosis and chronic pelvic pain?

Endometriosis is a common cause of chronic pelvic pain, accounting for approximately 21% of chronic pelvic pain cases. Chronic pelvic pain can occur with or without endometriosis.

4. What is the Endometriosis Management Plan?

A management plan in general practice identifies the patient’s health and care needs, sets out the treatments and services to be co-ordinated by their clinician, and lists the goals and actions the patient can take to help manage their condition. GP chronic condition management plans are intended for patients that would benefit from a structured approach to managing their chronic condition(s). The EMP can be used for GP chronic condition management planning. The EMP is patient-centred, encouraging patient input into their care planning and assisting in navigating their complex and sometimes multi-disciplinary care, and is designed to capture comprehensive, accurate and up-to-date information about a patient’s condition and treatment, and support the diagnosis and management of endometriosis and CPP for providers and their patients.

5. How is this different to what has been done previously?

Management plans are produced for many chronic conditions in primary care but until now, there has not been a nationally-available management plan for endometriosis. The EMP is patient-centred, electronic, interactive, and integrates the latest guideline recommendations for diagnosis and management of endometriosis. The downloadable plan reflects clinical recommendations for diagnosis, management and referral for patients with endometriosis and CPP.

6. Why will women with endometriosis and chronic pelvic pain benefit?

The evidence-based EMP has been co-designed with clinicians, patients and other stakeholders to ensure it is accessible, easy to use, and supports shared decision-making. It also provides access to credible and relevant information for both patients and clinicians. The management plan enables clinicians and patients to collaboratively manage the condition.

7. Will all GPs use it or do patients need to go to special clinics?

All GPs can use the EMP as it is freely available and accessible via the RACGP website.  

8. What does an EMP look like?

Once completed, the EMP can be downloaded and saved to the patient’s medical record. It can also be printed for a patient at the end of the consultation, to take home or emailed to them. The EMP will be a few pages long, with easy-to-read tables outlining the patients’ medical history, main concerns, goals, treatment and self-management strategies, and referrals, that were populated when completing the plan. Any assessments or resources selected will also appear in the plan, for patients to refer to.  

9. What is the EMP toolkit?

The Implementation toolkit is a ‘how to’ guide to assist clinicians using the EMP. It provides practical guidance to help clinicians apply the EMP in real-world settings by highlighting key information relevant to different situations that patients may present. Used alongside the EMP, it supports clinicians and patients to effectively manage endometriosis through tailored, structured care. For GPs and nurses the toolkit provides:

Practical guidance on how to use the EMP.

A one-page management pathway flowchart that shows GPS and nurses the steps to follow when supporting a patient with endometriosis-related symptoms.

A point of care resource which provides evidence-based information that may assist clinicians in recognising key information and facilitating informed decision making.

For clinicians working together with their patients the toolkit provides:

A patient guide, ‘How can an Endometriosis Management Plan help you?’, to help patients understand the experiences and path they will follow in their care journey.