Neria Irumva developed an ovarian cyst at 19 years old — and while the cyst eventually went away without medical intervention, she knows she could develop more cysts in future.

The Monash University student may have polycystic ovarian syndrome (PCOS), a hormonal condition that impacts the ovaries and can cause ovarian cysts, as well as other complications such as uterine issues and infertility.

But even before knowing the nature of the cyst or if treatment was needed, Irumva said, her healthcare provider recommended that she start contraceptive pills.

“Their first suggestion was just for me to go on the pill, before anything ... before I even had any ultrasounds,” she said.

While the cyst resolved itself as it was being monitored, Irumva didn’t want to begin taking contraceptive pills due to possible side effects. 

She felt that her practitioner’s suggestion highlighted possible blind spots in pain and medical treatment for female patients.

Indeed, women’s health has received record funding in the latest State and Federal Budgets — but experts say there’s still a way to go.

A reform agenda

This year, the Australian Government has committed to changes in women’s health, including over $500 million in funding, while Victoria will invest more than $150 million into services.

The Federal Government has pledged to support various initiatives such as contraceptives, menopause support, and women experiencing endometriosis and polycystic ovary syndrome (PCOS).

Victoria is also set to open five new women’s health clinics this year, in line with its 20-clinic goal, which will offer free healthcare for women and girls.

These initiatives follow the Victorian Government’s Inquiry into Women’s Pain in 2024.

Parliamentary Secretary for Women’s Health Kat Theophanous told MOJO News that Victoria had recently begun pelvic pain education in schools.

“We want young people to be empowered to understand their bodies and seek care when they are in pain,” Theophanous said.

The continued push for education is designed to assist in “reducing the long and often traumatic delays in diagnosing conditions like endometriosis”, she said.

Endometriosis is a condition where tissue, similar to that of the uterine lining, grows outside of the uterus. Symptoms can include severe pain particularly during menstruation and, in some cases, infertility.

The number of endometriosis-related hospitalisations has doubled over the past decade, from 330 hospitalisations per 100,000 to 660 per 100,000 among women aged 20-24.

These government-funded initiatives are being implemented alongside other non-government reforms.

The University of New South Wales has received a $50 million donation to establish the world’s first endometriosis research institute, which will have a significant impact on the currently under-researched condition and the lives of the women experiencing it.

The Head of the Department of Obstetrics and Gynaecology at Monash University and the Director of Gynaecology and Research at Monash Health, Professor Beverley Vollenhoven, said the increasing support of women experiencing endometriosis has been beneficial.

The Federal Government has made some medical management of endometriosis more accessible by "improving the PBS [Pharmaceutical Benefits Scheme] structure for some oral contraceptive pills, but also some endometriosis specific medication”, she said.

Women experiencing menopause will also receive more Medicare support, and new menopausal hormone therapies will be listed on the PBS for the first time in more than 20 years. 

A priority on cultural sensitivity

Theophanous said that among the clinics and services being established, Indigenous health services remain essential for communities.

“First Nations women and women from multicultural communities continue to report discrimination and cultural insensitivity in the health system,” she said.

“For many, that means avoiding care altogether or enduring care that does not feel safe or respectful.”

The Federal Budget includes allocating $16 million to provide rural and remote healthcare, which will go towards maternal health services to Indigenous communities, providing First Nations women with perinatal healthcare that is culturally appropriate.

Jill Gallagher, Chief Executive of the Victorian Aboriginal Community Controlled Health Organisation, said Indigenous women face challenges including racism and a lack of trust in services when accessing healthcare that is not culturally appropriate.

She said that these factors must be taken into consideration when improving healthcare and support for First Nations women.

It is important to “develop educational program[s] on how racism impacts health and wellbeing.”

She said it should be “mandatory for all health service [workers to] undergo Aboriginal cultural safety training”.

Access and education

Vollenhaven said that it’s vital to have accessible women’s healthcare, especially in rural areas.

“I have a lot of patients who live rurally and their access to detailed ultrasounds, for example, is pretty abysmal.”

New and expanded hospitals across Victoria will allow more women to give birth locally, rather than having to travel to do so.

Vollenhoven also said that many of the health-related issues women face stem from disbelief about their pain.

“There’s a lot of discussion now about women’s health and how women react differently in different circumstances, for example, a heart attack, [and] how women’s pain can often be dismissed,” she said.

The Australian Institute of Health and Welfare found that women are more likely to be affected by chronic pain than men across age groups from 45 and over, but are less likely to receive treatment for it.

Vollenhoven said educating professionals was integral to ensuring women get the services they need.

The medical field must focus on the “education of doctors about the different ways that women may present in certain conditions, and also the different ways pain can be perceived in women”, she said.

Theophanous said the recent initiatives to women’s health were hopeful, but it was important to continue to work towards further goals.

“State and federal reforms signal a long-overdue shift toward treating women’s health as essential, not optional,” she said.

“I want to see medical research be inclusive of women’s health in a much more sustained and deliberate way ... and I want to see a shift away from the stigma that has plagued women’s health for far too long.”