Victoria has issued its first standard on women’s pain, requiring clinicians to treat it as a symptom to investigate rather than dismiss or simply endure. GPs are on the front line.
Victoria released its first standards on women’s pain yesterday, setting out what women should expect from care and the principles health professionals and services must follow.
Its core principles are that all women are taken seriously and believed when discussing pain, listened to and supported in asking questions, respected as partners in decisions about their bodies and care, and provided with choices and practical support to manage pain safely and effectively.
This included discussing pain relief options before and during gynaecological procedures, including IUD insertion, as well as timely diagnosis, accessible, culturally safe and inclusive care that recognises past trauma.
The standards will be embedded across all public health services, including the 20 women’s health clinics and 20 sexual and reproductive health hubs in the state, which are set to be fully operational by late 2026.
“High-quality pain care is not one-size-fits-all, but what must remain consistent is the standard of care: every woman should be treated with dignity, respect and compassion,” the state department of health said.
The inquiry into women’s pain, which heard from 13,000 women and girls, found in its final Bridging the Gender Pain Gap report that 90% of respondents had experienced pain lasting longer than a year, and 54% lived with pain each day.
Respondents reported that their pain affected every aspect of their livelihood, including their work, relationships and ability to participate in everyday activities.
The most prevalent conditions associated with pain were menstrual and hormonal conditions (40%), followed by endometriosis (26%) and musculoskeletal problems (26%). In Australia, it can take up to 10 years for an endometriosis diagnosis.
The highest reported barriers to accessing care were widespread dismissal from healthcare professionals (71%), high costs (68%), long wait times (62%), and delayed diagnosis (53%).
“Many women face an added burden of having their pain minimised, normalised or overlooked. When women’s pain is not taken seriously, diagnosis and treatment can be delayed, causing them to miss out on timely and appropriate care,” the state department of health said.
Associate Professor Magdalena Simonis, a GP, women’s health expert and longstanding member of the RACGP Expert Committee for Quality Care, told The Medical Republic that a woman’s first encounter with the health system is crucial and can set the pattern for all subsequent interactions if she doesn’t feel heard.
“If a woman does not feel listened to, she will be less likely to return, and the condition might deteriorate,” she said.
According to the report, GPs were the most common first point of contact with the healthcare system, accounting for 91% of instances.
“From as early as possible, girls should be adequately informed that pain that is severe enough to stop a person from participating in their daily activities – whether it be cyclical or not – should not be accepted and should be responded to empathically by their doctor [or] health professional and managed or investigated further,” she said.
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The longer a woman endures a chronic condition causing pain, the more likely her mental health will also suffer, Professor Simonis said.
According to the inquiry’s report, 89% of respondents reported that pain affected their mental health, with half experiencing tiredness and low energy.
Professor Simonis called for both community awareness and further training for health professionals.
“Marginalised women need care provided in their language with better use of interpreters also, as they tend to be more likely rushed through the consultation or dismissed,” Professor Simonis said.
Dr Sara Whitburn, medical director of Sexual Health Victoria and chair of the RACGP sexual and reproductive health specific interest group, called the standard a “starting point” for improving dialogue between women and healthcare professionals.
But goodwill only goes so far without funding to match, she told TMR.
“Additional government support for longer consultation rebates would enable GPs to dedicate the time required for this important work,” Dr Whitburn said.
Women often prefer to see female GPs, who tend to undertake longer, more complex consultations without sufficient MBS reimbursement, a mismatch contributing to the attrition of female doctors.
“Increased investment in women’s health research, as well as expanded funding and training opportunities, would further strengthen implementation of this standard,” she said.
The RACGP joint initiative with Sexual and Reproductive Health Australia, AUSLARC, offers scholarships and grants for clinicians to learn long-acting reversible contraception insertion and removal, with a strong focus on pain-centred management, Dr Whitburn told TMR.
The college has also produced an IUD insertion guide covering pain management, with a further webinar on sexual health, psychology and pain management planned later this year.
The initiative forms part of a broader investment into improving women’s health in Victoria, the state government said.
