The Economic Burden of Endometriosis: What Australian Data Reveals.
Endometriosis affects at least one in seven Australians, yet its economic and societal burden remains profoundly underestimated. Beyond pain and delayed diagnosis, the financial impact on individuals, families, workplaces, and the health system is enormous. Two major datasets, from the Australian Institute of Health and Welfare (AIHW) and the Ernst & Young (EY) economic burden report, provide the clearest picture we have of this impact
Together, they reveal a chronic condition marked by high healthcare utilisation, substantial productivity losses, and preventable long-term economic consequences.
1. Healthcare utilisation and surgical burden
AIHW reports approximately 44,000 hospitalisations for endometriosis every year in Australia. A significant proportion of these involve laparoscopic procedures for diagnosis and treatment. Surgery is therefore not an “extra”; it is built into the care pathway for many.
Beyond surgery, direct healthcare utilisation typically includes:
repeated specialist reviews
diagnostic imaging (ultrasound, MRI)
multidisciplinary support
pain medicine
hormonal management
fertility care
mental health support
Fragmented pathways, variable access to multidisciplinary services, and differing surgical approaches may contribute to repeat hospitalisations and repeat surgeries are well-recognised cost drivers in chronic pelvic pain management
2. Productivity loss: the largest component of the cost
The EY Endometriosis Costing Report estimates the annual economic burden of endometriosis in Australia at $9.7 billion, with roughly 60–70% attributable to productivity loss rather than healthcare costs.
This includes:
absenteeism (sick leave)
reduced work hours
presenteeism (working through pain with reduced capacity)
career interruption or role changes
reduced educational participation
reduced capacity for unpaid labour such as childcare
EY estimates productivity losses of approximately $30,900 per person per year, higher than many other chronic conditions and disproportionately affecting younger adults in their peak working and reproductive years.
3. Out-of-pocket costs and cumulative personal burden
While system-level costs are large, the personal financial toll is often even more immediate. People with endometriosis commonly face:
private gynaecology and allied-health fees
travel and accommodation for specialist care (especially for rural and remote patients)
fertility treatment
mental health support
additional costs after surgery (childcare, home support, transport)
ongoing pain management aids
These financial pressures interact with pain, fatigue, and the emotional impacts of repeated medical encounters — collectively influencing quality of life and long-term wellbeing
4. Peri-operative recovery: could it be an under-recognised cost lever?
AIHW hospitalisation data and emerging recovery research highlight a critical issue: post-operative care for endometriosis is poorly standardised, under-supported, and often inconsistent.
Yet the peri-operative period has enormous influence on outcomes:
time to mobilisation
risk of complications
length of stay
opioid requirements
speed of return to work or study
risk of symptom recurrence
likelihood of needing repeat surgery
Enhanced recovery and prehabilitation models, widely used in other surgical areas, can improve outcomes through education, psychological preparation, nutrition, movement, and sleep optimisation. These models can be delivered effectively through digital platforms, especially for those who cannot access multidisciplinary care in person.
Given the volume of surgeries reported by AIHW and the high recurrence rate noted in major guidelines, peri-operative optimisation remains a major untapped opportunity to reduce costs and improve quality of life.
In summary:
The AIHW and EY data show that endometriosis is not only a complex health condition but also a significant economic and social issue in Australia. High rates of hospitalisation, frequent reliance on surgery, and limited access to coordinated care all contribute to the burden felt by individuals, families, workplaces, and the health system. Productivity losses make up the largest share of the national cost, reflecting how deeply symptoms affect daily life, work, and wellbeing. Understanding this broader picture helps explain why improving support across the entire care pathway — especially around surgery — is so important. When people receive timely, clear, and connected care, outcomes improve, the burden is reduced, and recovery becomes more predictable and less overwhelming.
References:
Australian Institute of Health and Welfare. (2021). Endometriosis in Australia: Prevalence and hospitalisations 2019–20.
Australian Institute of Health and Welfare. (2023). Endometriosis — Australian hospital statistics.
Ernst & Young. (2020). The cost of endometriosis in Australia: An analysis of the social and economic burden.
Armour, M., Parry, K., Manohar, N., Holmes, R., Cicuttini, F., & Abbott, J. (2019). The costs of endometriosis: A systematic review and meta-analysis. BJOG.
Armour, M., Sinclair, J., Chalmers, K. J., Smith, C. A., & Abbott, J. (2019). Prevalence and impact of dysmenorrhea on quality of life among young Australian women. Australian Family Physician.
Rowlands, I. J., Abbott, J. A., Montgomery, G. W., Hockey, R., Rogers, P., & Mishra, G. (2018). Prevalence and incidence of endometriosis in Australian women. BJOG.
Productivity Commission. (2023). Advancing women’s economic equality.
The Treasury. (2022). Measuring productivity in Australia.
Endometriosis Australia. (2020). Economic impact highlights.
Royal Australian and New Zealand College of Obstetricians and Gynaecologists. (2021). Endometriosis Clinical Practice Guideline.
European Society of Human Reproduction and Embryology. (2022). ESHRE Guideline: Endometriosis.