Endometriosis and adenomyosis: diagnosis and management

Endometriosis and adenomyosis are common chronic gynaecological conditions with significant health and economic impacts. Endometriosis and adenomyosis present with diverse and overlapping symptoms and can coexist. Symptoms may include pelvic pain, dysmenorrhoea, heavy menstrual bleeding, fatigue and subfertility, contributing to impaired quality of life and reduced participation in work, education and social activities. General practitioners are often the first point of contact and play a critical role in early recognition, preliminary diagnosis, initiation of treatment and referral. The current Australian guideline supports clinical diagnosis and early management without waiting for surgical confirmation. First-line management includes analgesia and hormonal therapies, tailored to patient priorities, goals, fertility intention, comorbidities and concomitant medications. Timely investigation, person-centred care and appropriate referral are essential to reducing diagnostic delay, symptom burden and long-term impacts.