Endometriosis — NZ Condition Guide | KiwiMeds

What is Endometriosis?

Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus — on the ovaries, fallopian tubes, bladder, bowel, and other pelvic structures. It causes chronic pain and can affect fertility. Endometriosis affects around 1 in 10 women and people assigned female at birth of reproductive age in New Zealand.

Overview

Endometriosis symptoms include painful periods (dysmenorrhoea) — pain worse than typical period cramps, often requiring time off work or school; pelvic pain outside of periods; pain during or after sex; painful urination or bowel movements during periods; heavy periods; fatigue; and difficulty getting pregnant. Symptoms vary widely — some people have severe endometriosis with minimal pain, others have mild disease with severe pain. Average time to diagnosis is 7–10 years — this delay is a significant concern and advocacy focus.

Treatment in New Zealand

Endometriosis has no cure, but symptoms can be managed. Hormonal therapies suppress the menstrual cycle and reduce pain: the combined oral contraceptive pill (OCP), progestogen-only pill, Mirena IUD (levonorgestrel), and GnRH analogues (leuprorelin — funded by Pharmac for eligible patients) are all options. NSAIDs and paracetamol help manage pain. Surgery (laparoscopy to remove or ablate endometriosis deposits) can relieve pain and improve fertility. A multidisciplinary approach (gynaecologist, pain specialist, physiotherapist, psychologist) is often needed.

NZ-Specific Information

Endometriosis NZ (nzendo.org.nz) provides advocacy, information, and peer support. NZ has significant diagnosis delays — Endometriosis NZ is working with the Government to improve awareness and referral pathways. Pharmac funds GnRH analogues for eligible patients.

Frequently Asked Questions

Does endometriosis mean I cannot have children? Not necessarily — many women with endometriosis conceive naturally or with fertility treatment. The impact on fertility varies with severity. Is endometriosis the same as period pain? Normal period pain is different. Endometriosis pain is typically more severe, often prevents normal daily activities, and may occur outside of periods.

Supplements That May Support Management

⚠️ Important: The supplements listed below have varying levels of clinical evidence. They are not a substitute for prescribed medications and should only be considered as adjunctive support under the guidance of a qualified healthcare professional. Always inform your GP or pharmacist before commencing any supplement, as interactions with prescribed medicines are possible.

• Omega-3 Fatty Acids — Omega-3 fatty acids reduce prostaglandin E2 and leukotriene production that drives the inflammatory pain characteristic of endometriosis. Supplementation at ≥2 g EPA+DHA/day has demonstrated reductions in dysmenorrhoea severity and pelvic pain.
• Vitamin D — Vitamin D deficiency is more prevalent in endometriosis and is associated with greater disease severity. Vitamin D has immunomodulatory effects that may reduce endometriotic lesion activity via regulation of T-cell and NK-cell function.
• N-Acetylcysteine (NAC) — A randomised trial demonstrated that NAC at 1.8 g/day over 3 months significantly reduced endometrioma size and pain scores compared to placebo, providing compelling evidence for its antioxidant and anti-inflammatory role in endometriosis management.
• Magnesium — Magnesium reduces prostaglandin-mediated uterine cramping. Supplementation at 300–400 mg/day supports smooth muscle relaxation relevant to dysmenorrhoea in endometriosis.
• Resveratrol — Resveratrol has demonstrated inhibition of endometrial cell proliferation and anti-angiogenic effects in preclinical studies. A small human trial showed reductions in dysmenorrhoea and lesion markers. More clinical data is needed.

Relevant Vaccinations

Individuals living with endometriosis may benefit from the following vaccinations. Please discuss your vaccination status with your GP or practice nurse, as eligibility and funding through the New Zealand National Immunisation Schedule may apply.

• Influenza (annual) — General preventive health recommendation. Illness-related inflammation can exacerbate endometriosis pain.
• HPV — Women with endometriosis are not at inherently higher HPV risk but should maintain age-appropriate HPV vaccination.
• COVID-19 — COVID-19 can cause systemic inflammation exacerbating endometriosis flares. Maintaining vaccination is recommended.

Dietary Guidance

Evidence-based dietary modifications play a meaningful role in the management of endometriosis. The following foods are generally recommended as part of a balanced, condition-appropriate diet. A referral to a registered dietitian may be beneficial for personalised nutritional planning.

• Anti-inflammatory Mediterranean pattern — Mediterranean dietary adherence is associated with reduced endometriosis risk and symptom severity in prospective studies, through reductions in inflammatory prostaglandins and oestrogen-promoting adipose tissue.
• Oily fish (omega-3 source) — Dietary omega-3 reduces prostaglandin E2 that mediates endometriotic pain and promotes lesion growth.
• Cruciferous vegetables — Indole-3-carbinol supports hepatic oestrogen metabolism, favouring clearance of more potent oestrogen metabolites relevant to oestrogen-driven endometriosis.
• Limit: red meat, trans fats, refined carbohydrates — High red meat and saturated fat intake is associated with increased endometriosis risk in epidemiological studies, likely through pro-inflammatory eicosanoid pathways and oestrogen metabolism effects.
• Limit: alcohol — Alcohol increases circulating oestrogen levels, potentially stimulating endometriotic lesion growth and inflammation.

Related Conditions & Medications

Related conditions: PCOS, Chronic Pain.