First published: 19 August 2025 by Katherine Ellis, Alina Meador, Anna P. Ponnampalam, Rachael Wood
ABSTRACT
This article details the findings of semi-structured interviews with nine GPs from Aotearoa New Zealand. These GPs highlighted the challenges associated with the treatment of endometriosis patients within an overloaded public health system, particularly with limited access to specialist gynaecology services. GPs highlighted that there were also elements within the backgrounds of patients that could make them more or less likely to present to the clinic, and to then feel open to discussing endometriosis-related symptoms. The GPs of this study indicated that having specialist endometriosis GPs or nurses, along with updated guidelines and enhanced access to multidisciplinary care for their patients would improve endometriosis care in Aotearoa New Zealand.
Background
General practitioners (GPs) are gatekeepers to specialist attention for endometriosis in the public system in Aotearoa New Zealand (Aotearoa-NZ). Their perspective of the endometriosis care landscape in Aotearoa-NZ has not been previously assessed.
Design
Semi-structured interviews.
Participants
Nine GPs self-selected to participate in interviews that were 13–28 min in duration to discuss their perspectives on endometriosis care.
Objective
These interviews included their views on existing guidelines, common characteristics of endometriosis patients, and what the future of endometriosis care could look like.
Results and Discussion
The GPs of this study expressed that the overloaded nature of specialist appointments in the public health system compromised the care of endometriosis patients. Resultingly, patients were subject to challenging journeys through diagnosis and management exacerbated by these health system factors. Furthermore, GPs identified that there were challenges that could prevent patients from presenting to the clinic to share their health concerns, such as a lack of awareness of ‘normal’ and pathologic menstrual-related symptoms. Once in the clinic, patients can struggle to feel they can talk openly with their GP, due to issues such as cultural taboos around discussing menstruation. The GPs highlighted that necessary avenues to improve endometriosis care require investment into the public health system to improve its function. They also highlighted potential solutions to improve care that can be incorporated into the existing system, including expanded endometriosis guidelines, improved relationship-building and introducing endometriosis specialist GPs or nurses.
Patient or Public Contribution
Two of the authors who designed the study approach, interpreted the data and prepared the manuscript were assessed and treated for endometriosis symptoms.