Australian living evidence guideline: endometriosis – 2025

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG)

Abstract

The Australian Living Evidence Guideline for Endometriosis, published in May 2025 by RANZCOG, offers the latest scientific evidence for detecting, diagnosing, and managing endometriosis. A Living Evidence Guideline incorporating current research to provide evidence-based recommendations to health care practitioners who diagnose and manage people with suspected or confirmed endometriosis or adenomyosis.
The new guideline aims to improve consistency of care for people living with endometriosis, and will reduce reliance on invasive laparoscopic surgery, which had been the gold standard in endometriosis detection and diagnosis for decades. Instead, these evidence-based guidelines prioritise less invasive medical imaging techniques to facilitate earlier diagnosis and treatment of endometriosis and ultimately reduce the pain and cost for the patients affected by the disease.
This guideline emphasizes non-invasive diagnostic methods and includes specific resources for primary care providers and patients.
Key features of the guideline included such positions:

• Focus on non-invasive diagnosis. The guideline promotes the use of transvaginal ultrasound and MRI as first-line diagnostic tools, reducing reliance on laparoscopic surgery.
• Patient-centered approach. It includes resources to help patients understand endometriosis, navigate their care journey, and manage symptoms, including emotional and psychological well-being.
• Specific recommendations for primary care. A quick reference guide and flowchart are provided to support general practitioners in the early detection and management of endometriosis.
• Living guideline model. The guideline is regularly updated with new evidence to ensure it reflects the latest research and best practices.
• Emphasis on education. The guideline stresses the importance of educating patients about endometriosis, its management, and the potential impact of treatments like hormonal contraception.
• Addresses related conditions. The guideline also addresses adenomyosis, a related condition often associated with endometriosis.