Dr Angstetra’s Journey to Providing Better Care for Women with Endometriosis

A Fact Sheet by A/Prof Donald Angstetra

I remember her vividly. She was hunched over in pain in the hospital’s emergency department where I was doing my junior registrar training. She was a 23-year-old university student who had been suffering since her first menstrual period and had been back and forth to the family doctor on numerous occasions, only to be told ‘it was normal’; that it was ‘part of being a woman’.

She had gone through multiple investigations including blood tests, urine tests, ultrasounds, and physical examinations and yet she still had no answers. This isn’t surprising. Endometriosis has traditionally been under-recognised among the medical community, leading to a diagnosis taking up to 10 years. This is not acceptable.

Seeing this young woman suffering with severe endometriosis but being told nothing could be done inspired me to start cultivating interest in developing and applying minimally invasive surgical techniques for these diseases.

I spent more than two years training at Sydney South West Area Health Service as a pelvic surgical fellow, mastering the advanced surgical treatment of endometriosis and complex pelvic surgery.

On my first day as the on-call specialist at the Gold Coast University Hospital, I was able to perform my first endoscopic surgery on a patient that presented with a large ovarian cyst, despite some resistance from my senior colleagues. It was a success.

For women in Australia, the endometriosis journey is not easy. 56% of women usually go through six or more doctor discussions before they receive a proper diagnosis.

I have been working vigorously to raise the standards and improve the quality of treatment and accessibility of surgical care for women. My work as a gynaecologist means I have been able to help thousands of women with diagnosis, pain and symptom management, high quality surgical intervention and, what can sometimes be the most important part of the journey, listening to them. Sadly, so many women feel that their pain has never been validated; that their cries for help have gone unheard.

While talking with one of my patients, I learnt that after her daughter’s recent endometriosis diagnosis, her gynaecologist told her that she was probably infertile and unable to have kids without IVF.

I have worked with many women who struggle to conceive, and know that endometriosis can contribute to infertility, but for anyone concerned that their endometriosis may effect their ability to have children, please know that this is true for only 30% of women, and in many circumstances, women can conceive naturally after surgery.

Often, laparoscopy can help a woman to conceive on her own without requiring additional fertility treatments, however IVF is an option for those who may experience difficulty falling pregnant.

Since that first experience with endometriosis as a registrar, I am now a senior consultant obstetrician and gynaecologist at Gold Coast University, Robina and Gold Coast Private Hospitals.

That experience sparked my interest in this condition and I have spent the last 15 years trying to raise awareness and improve treatments for endometriosis.

My passion for advanced gynaecological laparoscopic surgery has lead me into roles as the training-site director of the Australian Gynaecological Endoscopy Society (AGES) and as a training supervisor for The Royal Australian and New Zealand College of Obstetricians and Gynaecologist (RANZCOG) training program. I have recently been appointed as an honorary Associate Professor at Bond University where I continue to maintain my strong interest in women’s health and endometriosis research.

I work in collaboration with “QENDO” and have been helping them to raise awareness of endometriosis on the Gold Coast, northern NSW and surrounds. I have been tirelessly educating both the public community and other healthcare professionals about the myths and facts of endometriosis.

I believe education is vital to ensure women are diagnosed earlier and receive prompt intervention and management.

I encourage all women with endometriosis to not suffer in silence. Reach out to support groups, each other and look for a doctor who is ready to actively listen. Remember, you are not alone. And help is out there.