Gordon Reid (Robertson, Australian Labor Party) Share this | Hansard source

I thank all the members who have contributed to this really important topic today, especially the members for Lalor and Bendigo for moving the motion but also a member that's not in the chamber at the moment, Matt Burnell, the member for Spence, who has been a tireless advocate for those suffering from endometriosis. Thank you for all of the work that you do. Thank you to all of the members in the chamber who get behind those patients and those family members who are suffering from endometriosis.

What I am going to do today is go through a little bit about what endometriosis is, some of the clinical features and management, the treatment of it and then how the government is responding to endometriosis. As a doctor, I'm going to take the avenue of some of the patients that I have seen with endometriosis and how it can present and also some of the less common presenting signs and symptoms that some people who are listening at home might not be aware of.

Endometriosis is defined as endometrial glands and stroma that occur outside the uterine cavity. These endometrial lesions are typically located within the pelvis but can also occur in other parts of the body. They can occur in places like the bowel, the diaphragm and the pleural cavity, which is the bit that lines the lungs. They can cause symptoms that range quite significantly and can be very, very severe and debilitating for women who are suffering from endometriosis.

Classically, women will present during their reproductive years with symptoms including pelvic pain, dysmenorrhea, dyspareunia, infertility and ovarian masses.

A division having been called in the House of Representatives—

Sitting suspended from 12:57 to 13:33

As I was saying, endometriosis has a peak prevalence occurring particularly in those aged 25 to 35. However, it has been reported clinically in premenarchal girls and also in postmenopausal females. Really, this is a disease which affects women right across the lifespan—especially with some of those other symptoms I was talking about.

Some of the common symptoms of endometriosis that have been reported include things like chronic abdominal and pelvic pain; bloating and pressure; severe dysmenorrhoea and dyspareunia; heavy menstrual bleeding; and infertility. These are just some of them, but there are additional symptoms if the endometrial lesions affect areas outside the pelvis. If they're affecting the bowel then we have bowel and bladder dysfunction—think of pain, urgency and frequency in urination; abnormal uterine bleeding, lower back pain and chronic fatigue, just to name a few. The constellation of symptoms that can occur with endometriosis is vast and affects every patient differently.

I'll just go through some of those. Dyspareunia can suggest the presence of deep endometrial lesions or peritoneal lesions. We think of the urinary symptoms that I was just describing. That can suggest bladder endometriosis. Diarrhoea, constipation and abdominal cramping can suggest bowel lesions. Abdominal pain can result from endometrial lesions in one of the less common sites, the abdominal wall. These are some of the rarer ones. The endometrial lesions can actually affect the thorax or chest cavity, causing things like recurrent chest pain, haemoptysis or the coughing up of blood and also pneumothorax, in which the lung can collapse and cause significant respiratory distress in patients. This isn't a disease that affects one part of the body; it can affect multiple parts of the body, and that's why early diagnosis and management of this condition is absolutely vital so that women are able to live healthy and productive lives.

Going into general principles of the treatment and management, that can include things that maximise medical treatment but also minimise the need for recurrent surgical intervention. Each treatment plan definitely needs to take into account the clinical presentation and severity of symptoms of all patients.

A division having been called in the House of Representatives—

Sitting suspended from 13:36 to 13: 46

I would like to acknowledge that the government is addressing endometriosis at a national level, with a significant investment, a $58 million package for endometriosis and pelvic pain which was announced in the 2022-23 budget, including funding for dedicated clinics, MRI scanners and assisting patients with endometriosis. The

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