Endometriosis takes an average of 10 years to be diagnosed in New Zealand. Photo / 123rf
A small team of doctors are “punching above their weight” to improve the lives of Whanganui endometriosis patients without leaving town.
Endometriosis is an inflammatory disease that causes severe period or chronic pelvic pain and affects 120,000 people across New Zealand.
Dr Paul Canning, a pelvic pain specialist at Whanganui Gynaecology, is one of five gynaecologists at Whanganui Hospital who treat endometriosis.
Canning said many patients said the pain was worse than childbirth.
“Lots of women are ... completely unable to work, unable to get off the bathroom floor during their period.”
Receiving care can be difficult. Endometriosis has long been widely underdiagnosed and under-researched.
It takes an average of 10 years to be diagnosed in New Zealand.
“It has a really huge impact on women’s lives.”
Endometriosis occurs when tissue similar to the uterus lining grows outside the womb.
It can spread to other parts of the body, including the pelvic ligaments, muscles, ovaries, bowel, lungs and, in rare cases, the brain.
It can lead to fertility issues or infertility.
Endometriosis has long been dismissed as a women’s issue with limited treatment options. Many women with endometriosis share stories of being told their pain is normal and they are just “bad periods”.
Canning said 30 years ago the default care option was a hysterectomy which was rarely necessary or always effective.
He said he was passionate about changing that.
“I think we can actually make a difference for women if we listen to them and give evidence-based treatment.”
Canning offers surgical and non-surgical options for patients.
“We’re quite lucky in Whanganui.
“Although we are a small unit, I think we do punch above our weight for what we’re able to offer here.”
Whanganui has a specialist, five gynaecologists who perform endometriosis surgeries, a pelvic floor physiotherapist, a pain specialist and counselling services.
“That’s probably the most important thing with endometriosis care ... it’s not just the surgeon.”
Whanganui Hospital is about a third of the size of Palmerston North Hospital. Whanganui has 137 beds while Palmerston North has more than 350.
Canning said that despite this, they could treat most patients locally. Only severe cases needed to go to Wellington Hospital, which has a severe endometriosis care unit.
“It is a resource-heavy condition because it’s not just me [treating patients], it’s also our whole team.”
Recent advancements in care have made treatment more accessible and efficient.
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) released new guidelines for endometriosis care in May last year.
The new guidelines said non-invasive diagnosis using an ultrasound or MRI scan should be the first step in treatment. Previously, laparoscopic or “keyhole” surgery was the only option to view and diagnose endometriosis tissue.
“There is really good evidence that in the hands of a skilled sonographer, you can diagnose endometriosis a lot earlier.”
Canning said this allowed patients to start treatment sooner.
Last October, a new medication specific to treating endometriosis symptoms was registered in New Zealand and Australia, the first in nine years.
Ryeqo is classed as a contraceptive and works to balance hormones connected to generating endometriosis tissue and symptoms.
Hormone therapy is not a new method but increasing available options is vital to finding what works for different bodies.
Many contraceptives and hormone pills can have severe and unpredictable side effects.
Canning said it was about finding what works for each individual.
“We do now have more options for medical treatment, but I think it sometimes can be a bit of a trial and error.”
Canning said rising awareness of endometriosis could lead to more GPs recognising it and helping people start treatment before seeing a specialist.
Awareness of the disease has risen globally in recent years.
The short film This is Endometriosis won the 2026 Bafta for Best British Short Film.
Canning said he was hopeful progress would continue.
“We still have quite a poor understanding of why some women get it and others don’t.”
He said more research was needed into understanding hormone therapy and the disease generally.
Adding a dietitian to Whanganui’s endometriosis team could improve patient care, Canning said.
“We want to get them back to living a normal life.”
Erin Smith is a multimedia journalist based in Whanganui.