First National Study Reveals Multi-Billion-Dollar Cost of Endometriosis and Chronic Pelvic Pain in Aotearoa New Zealand

A milestone study led by the Medical Research Institute of New Zealand (MRINZ) has revealed that endometriosis and chronic pelvic pain impose an annual economic burden of more than $22 billion on Aotearoa New Zealand — placing these conditions among the country’s most significant public health issues.

Published in MDPI Women, this is Aotearoa New Zealand’s first national cost-of-illness analysis for endometriosis and chronic pelvic pain. Using the World Endometriosis Research Foundation (WERF) EndoCost tool and updated health economic methodology, the study drew on detailed patient-reported outcomes, health service use, and productivity data from more than 120,000 New Zealanders affected — including women, girls, and people assigned female at birth.

Dr Jordan Tewhaiti-Smith, MRINZ Research Fellow and Registrar in Obstetrics and Gynaecology, led the work. He says the findings make clear the scale and urgency of the issue.

“Our findings reveal decades of accumulated loss for those living with endometriosis and chronic pelvic pain. New Zealanders are carrying the direct costs of repeated appointments, investigations, interventions, and fertility care, alongside enormous indirect costs through lost income, reduced hours, and disrupted careers and education,” says Dr Tewhaiti-Smith.

“These figures reflect a major public health issue, consistent with the burden seen in other significant national health conditions such as Diabetes, Crohn’s, or Rheumatoid Arthritis. Yet the majority of costs fall disproportionately on individuals because of under-resourcing, inconsistent care pathways, and delayed diagnosis. For many, the financial impact begins in adolescence and compounds through adulthood.”

The study shows that productivity loss accounts for 65–75 percent of total costs. Many people lose work hours, take extended time off, or leave employment altogether because of severe pain, ongoing symptoms, and delayed access to specialist care. These impacts extend beyond individuals, affecting employers, workplaces, and broader economic participation.

Lilly, a 23-year-old from Ōtautahi Christchurch, first experienced symptoms at age 12 and has spent more than a decade seeking answers. Despite severe pain leading to repeated after-hours and emergency department visits, she is still waiting for a public gynaecology appointment.

Her symptoms have made full time work complicated, limited further employment options, and placed her under significant financial strain. Endometriosis New Zealand Chief Executive Tanya Cooke says the study confirms what those living with the condition have long experienced. “The financial, emotional and physical toll of endometriosis can be enormous, and too often New Zealanders are left to shoulder it alone. This study makes clear just how deeply the condition affects individuals, whānau, businesses, and ultimately the whole economy.”

Tanya says the findings reinforce the urgent need for coordinated national leadership. “Our current approach to endometriosis, which relies on fragmented, piecemeal initiatives, is failing New Zealanders. What we need is national coordination through the development and implementation of a National Endometriosis Action Plan, similar to Australia’s. Such a plan can drive earlier diagnosis, faster and fairer access to treatment, and meaningful support across workplaces, schools, and communities.”

Associate Professor Mike Armour (NICM Health Research Institute, Western Sydney University), senior author of the study, says the results align with international evidence while highlighting systemic gaps in New Zealand’s healthcare response. “Cost-of-illness studies worldwide consistently show that productivity loss is the dominant driver of economic burden. We now know that New Zealand is no exception,” says Dr Armour.

“This study places New Zealand firmly within the global context and highlights a pressing need for integrated, equitable models of care. Without system-level change, we will continue to see fragmented treatment, delayed diagnosis, and widening inequity for those most affected.”

Read the full media release HERE and view MDPI Women publication HERE.