This article first appeared in The House of Wellness magazine.
Endometriosis is a common inflammatory disease where tissue similar to the lining of the uterus is found outside the uterus and can drive inflammation, scarring and pain. It can cause (sometimes severe) period and pelvic pain, and impact bowel and bladder function, energy levels, sex and sometimes fertility. It’s estimated to affect around 1 in 10 girls, women and those assigned female at birth. Roughly 120,000 people live with the condition in New Zealand. With Endometriosis Awareness Month coming up in March, we chat with the CE of Endometriosis New Zealand, Tanya Cooke.
Can endometriosis be treated or is it more about learning to manage symptoms long term?
Endometriosis is usually a long-term and chronic condition. There isn’t a simple cure for it, but there is a range of treatments that can significantly reduce symptoms and improve quality of life. For many people, it’s about finding the right combination of treatments and care for them. A major challenge in New Zealand is that too many people can’t access timely diagnosis and therefore treatment. The average delay from first symptoms to diagnosis is close to 10 years in Aotearoa. For many, the wait is much longer.
Can diet and nutrition help?
There is no one-size-fits-all endometriosis diet. Those with endometriosis should seek tailored nutritional advice for their specific symptoms. However, we know endometriosis is an inflammatory estrogen-driven disease, so foods that can reduce inflammation and circulating estrogen levels are recommended, including a Mediterranean-style diet based around fruit, vegetables, olive oil, nuts, seeds, legumes, wholegrain carbohydrates, some dairy products and lean animal proteins.
Which treatments seem to offer the most relief?
This varies patient to patient. However, there is strong evidence that hormonal treatments can significantly reduce pain, and these do work for many. Surgery can also be very effective. Multidisciplinary care is now the global standard, with first-line clinical treatments combined with things like pelvic-health physiotherapy and pain-focused mental-health support. Women concerned should always seek further advice from their doctor.
What about complementary therapies, like acupuncture or breathwork?
Some complementary approaches can be helpful, particularly those that support pain regulation, stress reduction and quality of life. It is important that complementary therapies add to care and are not seen as a replacement for evidence-based assessment and treatment.
Where does medicinal cannabis fit into endometriosis care?
Medicinal cannabis is an area of growing clinical interest, but the evidence base is still developing and current research is limited with regards to endometriosis.
How closely are pain, fatigue and mental wellbeing connected?
They are very closely connected and it’s one reason that world-leading endometriosis care takes a multidisciplinary and holistic approach.
What should people know about endometriosis and fertility – and which myths need busting?
Endometriosis can impact fertility, but it does not automatically mean infertility. Many people with endometriosis can conceive naturally, while others do so through fertility support.
There are several concerning myths that still exist around endometriosis. Here are a few common ones:
• It’s normal to have distressing pain during your period. It’s normal to have some degree of discomfort during your period, but it should never be distressing enough to prevent you from carrying out day-to-day activities. If you’re forced to take time off work or school because of the pain, consult your doctor.
• Pregnancy cures endometriosis. Pregnancy is not a cure for endometriosis. This belief is an old myth based on incomplete research. Symptoms may occasionally trail off after having a baby, but it’s not a cure.
• Surgery cures endometriosis. Surgery can massively improve symptoms, but the endometriosis tissue can grow back even after the best surgery. There is no single-shot cure for endometriosis.
Why is raising awareness through Endometriosis New Zealand so important?
Too many people are still being dismissed, misdiagnosed or told to just live with their pain. The social and economic consequences are enormous for New Zealand across health, education, work, relationships and wellbeing.
Endometriosis New Zealand exists to provide trusted information, education and support for those with endometriosis. We also advocate for changes to have endometriosis better prioritised within our public health system. We know there are significant inequities out there, including based on where you may live and your financial circumstances. We are supported by a multidisciplinary clinical advisory committee to ensure our recommendations and advocacy are grounded in best practice.
Why is implementing a National Endometriosis Action Plan important?
New Zealand needs a coordinated, government-backed blueprint similar to Australia’s to tackle endometriosis and fix a currently fragmented and postcode-dependent system.
We are calling for a National Endometriosis Action Plan to drive:
• Earlier diagnosis (including through GP education and clearer pathways).
• More consistent and equitable access to treatment and multidisciplinary care.
• Better data and research, including New Zealand-specific evidence.
• Better outcomes for Māori, Pasifika and rural communities.
CASE STUDY:
Thirty-two-year-old Tae Foley says it’s time to start having honest conversations about endometriosis
After my most recent laparoscopy in 2024, I needed to step away from my career to focus on recovery and healing. I’ve created a podcast (launching in March) called Coffee & Cramps With My Life and Endo. It’s a space for women to talk openly about their lived experiences with endometriosis, fertility struggles and other women’s health conditions. My hope is that it helps create connections, encourages honest conversations and educates others about endometriosis and the challenges many women face.
What does living with endometriosis look like day-to-day?
Every day is different. Some days I can get through fairly normally and other days my body decides what I can and can’t do – from how much I can move to whether I have the energy to even get through the day. Managing pain and fatigue is constant, and it’s always a balance between listening to my body and trying to live a ‘normal’ life.
On top of the painful cramps or physical challenges, there’s the mental and emotional toll too. The unpredictability can be exhausting and I’ve had to learn how to plan, pace myself and accept that some days will be harder than others.
When did you first experience symptoms?
As a teenager, long before I had any real understanding of what endometriosis was. Honestly, after my first diagnosis I used to call it “endemendy” because I didn’t even know how to say it correctly. For a long time, it was just a medical term for “my bad periods”, and I didn’t really know what it actually meant.
How long was the journey from diagnosis to treatment?
I had keyhole surgery at 17 because my symptoms were so severe, but it wasn’t until my 30th birthday that I was finally diagnosed with stage 4 endometriosis and told that I might struggle to conceive my first child naturally.
Has treatment been effective?
Treatment has been ongoing and complicated. When I was younger, I didn’t really understand what endometriosis was, so I thought surgery was the only way to fix it.
It’s only more recently that I’ve come to understand the condition better – that it’s not just about the lesions themselves, but that inflammation plays a big role in how it affects the body. Managing it is about more than one approach. I’ve learned that paying attention to my body, noticing what triggers symptoms and finding ways to support my overall health can really make a difference. Things like nutrition, gentle movement, rest and self-care all help ease symptoms and make day-to-day life a little more manageable.
If you could tell someone who’s been newly diagnosed one reassuring thing, what would it be?
You are not weak and you are not imagining your pain and you are far from alone in this. Trust your body, advocate for yourself and know that it’s OK to have difficult days while still holding on to hope. Endometriosis doesn’t define your life or who you are. It’s just one part of your journey, and with the right support and understanding there is still space for happiness, purpose and moments of joy.
Anything else you wish to include?
Endometriosis isn’t just about periods. It affects your whole body and every part of life. Delays in diagnosis, lack of education and limited access to funded fertility treatments can have a lifelong impact. That’s why sharing experiences is so important. It helps raise awareness, educate others and promotes understanding, which can ultimately lead to real change.
This article is not intended as individual medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.
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