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NZ Herald
5 days ago
- Health
- NZ Herald
Christchurch endometriosis patient ‘rejected' by public health system
'But of course, later, when I ended up having the surgery, I was actually diagnosed with endometriosis.' Tory McArthur has been trying to get treatment for endometriosis for many years. Photo / Supplied McArthur was having pre-cancerous cells removed through a series of biopsies when the endometriosis was finally discovered. 'The specialist advised getting a second opinion about endometriosis because of the intensity of the pain of the procedures,' she explained. 'I had an internal ultrasound where they could see my ovary wasn't moving so was then referred back to gynaecology as they believed then that something wasn't right.' McArthur underwent surgery, and widespread endometriosis was finally confirmed. It was removed, and McArthur had a hormonal intrauterine device implanted. IUDs – like the Mirena – is a long-acting, reversible form of contraception that can be an effective treatment option for endometriosis, primarily by reducing pain and heavy bleeding associated with the incurable condition. Photo / Endometriosis New Zealand It took about 10 weeks for McArthur to recover, but afterwards she was 'relatively pain free' for three years. 'And then I had another bout of pain where I had to go to the hospital. I couldn't deal with it. I sat in the waiting room for about six hours,' she said. 'I was in excruciating pain. I was on the floor and I was crying and trying to hold my s*** together, because I didn't really want to make a scene – but in the end I wasn't able to hold myself up and I just keeled over. 'A doctor gave me a Panadol and said to 'wait it out' until someone was able to see me … I was sent back to the waiting room. The pain was an 11 out of 10 – I felt like my insides were ripping themselves out. 'It got to the point, at about 4am, where I said to my partner, 'Just take me home, we've been here for hours and no one's coming'. I ended up dealing with it at home by myself, taking Panadol.' McArthur at her last hospital visit, where she waited for more than six hours before her partner took her home without being seen. Photo / Supplied Since then, McArthur has been 'back-and-forth' with her GP, trying different pain management options. She is allergic to some medications, and others have not worked or made little difference. 'Three or four times over the last 18 months, I have tried to get a specialist appointment, but every single one has been declined,' she said. 'My GP refers me, and they say no. They say that, basically, I'm not dying and I don't have cancer, so I am not a high-priority person even though I am in so much pain. 'The last time I was hospitalised, over about four or five hours, I was given all up around six to seven doses of fentanyl and five to six doses of morphine to try and get the pain eliminated. 'They did send a couple of gynaecologists in to 'once over' me… one of them said to me that healthcare is the worst she's seen in 30 years, and that there was nothing they could do for me. 'For me, surgery is the only fix ... There is medication, but not every medication works for everyone. I've had my IUD for seven years, and it's great at masking some of the pain, but it's not great. 'And nothing stops endo from growing and spreading … and contraception is meant to slow it down, but I'm unsure what pace." McArthur says she has missed work because she is not well enough to function - but cannot get the medical help she needs. Photo / Supplied In June, McArthur's GP referred her again. Just last week a specialist appointment was confirmed but it is not for months and there is no guarantee of actual treatment. McArthur, a media coordinator at NZME and photographer, cannot afford private medical care at this point in her life. A single appointment with a gynaecologist costs upward of $400. She purchased health insurance so she can get treatment in future. 'But because the endo is a preexisting condition, I have to wait until a three-year stand-down period is up. I am one year into that and they have just put my premiums up $20 a fortnight,' she said. 'So I am paying tax for a public health system I can't access and a s*** load more for private care I can't use yet. 'I feel incredibly let down. I know that there are always people worse than me, but I contribute to society, I pay my taxes and being rejected by the public system ... it just sucks.' McArthur said her endometriosis was more than just pain - it has also impacted her mental health, and tests showed her capacity to have children has been reduced because of the condition. 'My fertility level has dropped a lot. I'm not infertile, but it's not the greatest ... I was told by my doctor last year that I should be trying to have children now if I want them,' she said. 'Pregnancy can improve endo symptoms, but there is no guarantee ... It's not healthcare to be told to 'have a baby'. And, it is basically pushing me into a corner to have to make these decisions before I am ready. Having a baby is not where we are at this present point in time.' McArthur shared her experience because she wanted to highlight the 'inadequate' health care for women in New Zealand. She knows a lot of other women living with crippling endometriosis and wanted to raise awareness around the issue. 'A lot of people are just like 'oh, it's just bad periods. But it's not just bad periods – endo is an all-over-body chronic illness. It has been found on every major organ in the body – it's not just your uterus, it can grow on your pelvis and bowel. It can also spread to other organs around your body – they have even found endo near the brain before. Tory McArthur and her partner Ben Hibbs. Photo / Supplied 'People need help. Seven years ago, I got the surgery I needed with no qualms, and it helped. For many of us, at the moment, surgery is the only thing that can kind of remove the scar tissue you have. 'I don't want to be in the emergency department, I don't want to be off work ... I want to have this issue fixed and not to have to worry about it.' McArthur could not remember the last day she was pain-free and comfortable in her own body. 'I operate at a pain level of anywhere from three to five every day. I'm always cramping, and I'm always bloated. It doesn't matter what food or drink I eat, and it doesn't make a difference if you diet. Last year, I lost 15kg and I was still in excruciating pain,' she said. 'I cut out caffeine for a year. I cut out alcohol for a year and a half. I went vegetarian for six months. I felt no difference. People have said 'go vegan' – I've done it all. 'I did pelvic floor appointments where they have to go basically inside you and massage your pelvic floor, and that is beyond excruciatingly painful – and it feels deeply violating and each appointment I left in tears. 'I also did endo cupping which is where they use the same cupping technique on athletes but on your lower abdomen to try to get the tissue layers to separate to loosening adhesions. It is still a freaking insanely painful process too as they not only apply the cups to your lower abdomen but also drag them back and forth trying to release scar tissue physically. I did that like 7-8 times. 'I've done so many different things and looked into so many different avenues of healing to try. I take antidepressants, I do therapy.' Endometriosis is the presence of ectopic endometrial tissues outside the lining of uterine cavity. It is a well known cause of chronic pelvic pain and infertility in females. Endometriosis of the appendix is rare and may present with acute or chronic abdominal pain. McArthur said there had been many times she felt people thought she was a 'hypochondriac' or was being dramatic about her pain. She felt that people dismissed women with endometriosis and thought they should 'just get over it'. 'People don't realise, it can be so debilitating. And for so long I haven't been listened to ... It's so infuriating. It's disappointing.' Endo care in NZ 'inadequate' - advocate Endometriosis New Zealand chief executive Tanya Cooke said the level of care for Kiwis with the condition was 'inadequate'. 'People with the condition face long diagnostic delays, on average nearly 10 years. There are also major barriers to accessing timely, effective treatment and specialist care,' she said. 'There is a severe shortage of endometriosis specialists, and a lack of awareness and education in primary healthcare. This often results in symptoms being dismissed or misdiagnosed, and even once diagnosis has taken place, a long wait for treatment.' Cooke said McArthur's experience was common. 'Sadly, this is a reality we hear all too often. With at least 120,000 people in New Zealand living with endometriosis, far too many are being left to manage debilitating symptoms without proper support or care,' she told the Herald. 'We need a National Endometriosis Action Plan, similar to Australia's, that can provide a coordinated response to endometriosis in New Zealand.' Tanya Cooke, chief executive at Endometriosis New Zealand. Cooke said a national plan would improve diagnosis through the implementation of standardised care pathways and better GP education, while developing improved access to treatment and support. 'It would also drive public awareness, help fund much-needed research, and ultimately improve health outcomes and the quality of life for the 120,000 or so New Zealanders with endometriosis,' she said. 'Endometriosis is a serious and under-recognised health issue with major personal, social, and economic impacts, this includes significant impacts on productivity and healthcare costs. It's time for meaningful, coordinated action to address it.' She urged people with the condition to learn as much as possible so they could strongly advocate for themselves. 'Including how to interact with your GP and the health system,' she said. 'Know that your pain and what you are experiencing is real, trust your instincts and have courage and confidence to advocate for yourself, and don't give up.' 'Significant pressure' on Health NZ services Health New Zealand chief medical officer Professor Dame Helen Stokes-Lampard acknowledged 'current wait times' were causing people with endometriosis 'distress'. 'Our health services continue to experience significant pressures due to sustained high levels of acute demand and workforce shortages, and this is having an impact on planned care,' she told the Herald. 'Our immediate focus is on urgent patients and those who have been waiting the longest for treatment. We continue to work hard to put in place systems and processes so improvements to waiting times are made.' Health New Zealand chief medical officer Professor Dame Helen Stokes-Lampard. Photo / Health New Zealand She did not respond to questions about what the agency would do in future to help patients. She referred to a 'best practice guidance' published in March 2020 that was 'developed by a taskforce' of health professionals, Endometriosis NZ and 'those who live with the condition'. 'It has been made available via the Health Pathways programme to all clinicians working in the community and focuses on early presenting symptoms and investigation,' she said. 'Health Pathways is a 'one stop shop' for best-practice, condition-specific guidelines and associated information. The online resource is designed for primary health care practitioners to use during consultation, helping them manage and refer their patients to the most appropriate specialist, hospital or community-based services. 'In general, the guidance aims to support early recognition of symptoms and empower primary health care practitioners to make a diagnosis and commence management. Referral to secondary care gynaecological services is only advised if the patient has uncontrolled symptoms that have not responded to treatment options in primary care.' Stokes-Lampard did not have any advice for people struggling to get treatment, nor could Health NZ provide any data on the number of people waiting or declined for specialist care. Endometriosis - the facts Endometriosis is a common inflammatory disease estimated to affect 176 million individuals worldwide in their reproductive years. It affects at least 120,000 New Zealanders - roughly 1 in 10 girls, women and those assigned female at birth. Endometriosis occurs when tissue similar to the lining of the uterus (endometrium) is found in places outside of the uterus. It can be also be found on the pelvic ligaments, ovaries and bowel. In most cases, there can be symptoms including period pain, pelvic pain and sub-fertility or infertility. The cause of endometriosis is not fully understood, though it is generally considered multi-factorial with a strong genetic link. Endometriosis seems to run in families, so you are more likely to have it if there is a family history. What are the symptoms? Pain with periods (dysmenorrhoea) is often the most common symptom. Bowel problems like bloating, diarrhoea, constipation, pain with bowel movements, painful wind - sometimes diagnosed as IBS. Painful intercourse (dyspareunia). Sub-fertility or infertility. Tiredness and low energy. Pain in other places, such as the lower back. Pain at other times, eg with ovulation or intermittently throughout the month. Abnormal menstrual bleeding. Bladder troubles like interstitial cystitis (IC). Source: Endometriosis New Zealand. For more information, click here. Anna Leask is a senior journalist who covers national crime and justice. She joined the Herald in 2008 and has worked as a journalist for 19 years with a particular focus on family and gender-based violence, child abuse, sexual violence, homicides, mental health and youth crime. She writes, hosts and produces the award-winning podcast A Moment In Crime, released monthly on
Scoop
11-07-2025
- Health
- Scoop
ProCare Welcomes Pharmac's Move To Improve Access To Asthma Inhalers And Long-Acting Contraceptives
ProCare welcomes Pharmac's announcement to improve access to some asthma inhalers and long-acting contraceptives from 1 August. The changes represent a significant step forward in supporting equitable, patient-centred primary care across Aotearoa. The changes will impact funded treatments, including: combination inhalers branded as Symbicort Turbuhaler, DuoResp Spiromax, and Vannair long-acting contraceptives branded as Mirena, Jaydess, and Jadelle. From next month, patients will be able to receive a three-month supply of the inhalers at once, and these, along with the long-acting contraceptives will be stocked in general practices for the first time. This change will reduce the need for people to visit their pharmacy to pick up their prescription and mean people can learn how to use their inhalers and collect them at the same time, rather than returning for a follow-up. Bindi Norwell, Chief Executive at ProCare sees the decision as a win for increasing accessibility to treatment and for efficiency of work in primary care. 'Reducing barriers to get timely access to treatment, especially for people managing chronic conditions like asthma means our health care professionals can help them get better health outcomes sooner. 'However, we do want to sound a warning to members of the public around the IUD insertions. As per Medical Council requirements, GPs are required to ensure that patients are informed and have time to ask questions before giving their consent to any procedure. Patients may need to book a double or triple appointment depending on the treatment chosen. Mihi Blair, Kaiwhakahaere Hauora Māori (General Manager - Māori Health and Equity) at ProCare believes these changes will mean the support provided to patients can be done more equitably. 'For Māori, Pacific peoples, and those living in rural areas, easier access to essential treatments can make a real difference to their health. It's encouraging to see Pharmac responding to the needs of our communities.' ProCare supports aligning medicine access with clinical guidelines and responding to how we can improve patient experience. The changes will help streamline care delivery, reduce administrative burden, and empower clinicians to provide timely, effective treatment. 'We look forward to working with our practices to implement these changes smoothly and ensure patients are informed and supported,' says Norwell.
Health Line
10-07-2025
- Health
- Health Line
How Is an Intrauterine Device (IUD) Removed?
For many people, having an IUD removed is a quick procedure performed in a doctor's office. But if the IUD has attached to your uterine wall, it may require a more involved removal. An IUD is a small, T-shaped device that's inserted into the uterus to prevent pregnancy. It's one of the most effective forms of reversible birth control, with fewer than 1 in 100 people becoming pregnant each year. What is an IUD? There are two types of IUDs: copper and hormonal. In the United States, the copper IUD is known as ParaGard. This T-shaped device contains a stem wrapped with copper wire and two copper sleeves. These parts release copper into the uterus for up to 10 years, preventing sperm from reaching the egg. Hormonal IUDs release progestin into the uterus, thickening cervical mucus to block sperm from reaching and fertilizing an egg. The hormone can also prevent eggs from being released and thin the uterine lining to prevent implantation. There are four different hormonal IUDs. Mirena and Liletta last the longest (up to 8 years). Kyleena works for up to 5 years, and Skyla works for up to 3 years. Removing an IUD A healthcare professional can remove your IUD at any time. You may consider removing it because: You're trying to get pregnant. You've had it for the maximum amount of time recommended, and it needs to be replaced. You're experiencing prolonged discomfort or other undesirable side effects. You no longer need this method of birth control. For most people, the removal of an IUD is a simple procedure performed in a doctor's office. To remove the IUD, your healthcare professional will grasp the threads of the IUD with ring forceps. In most cases, the arms of the IUD will collapse upward, and the device will slide out. If the IUD doesn't come out with a slight pull, your healthcare professional will remove the device using another method. You may need a hysteroscopy to remove the IUD if it has attached to your uterine wall. During this procedure, a doctor or other healthcare professional widens your cervix to insert a hysteroscope. The hysteroscope allows small instruments to enter your uterus. You may require anesthesia for this procedure. It can take between five minutes to an hour to complete a hysteroscopy. Recent research also indicates that an ultrasound-guided removal is an effective way to take out an IUD that won't come out with forceps. This procedure can be less invasive than a hysteroscopy and more cost-effective. Living with an IUD Once you have an IUD placed, you're protected against pregnancy for three to 10 years. The duration that your IUD protects against pregnancy depends on the type of IUD that you choose. You'll have a follow-up appointment about a month after the IUD is inserted. During this appointment, your healthcare professional will make sure the IUD stays in place and hasn't caused an infection. You should also confirm that your IUD remains in place on a monthly basis. After insertion, its strings will hang down into your vaginal canal. You can verify that the IUD is still in place by checking for these strings. You shouldn't be able to touch the IUD. You should contact a healthcare professional if: you have unusual bleeding penetration is painful you can feel other parts of the IUD in your cervix or vagina If you have a copper IUD, you may experience heavier periods accompanied by menstrual cramping. This is usually temporary. Many people find that their cycles regulate two to three months after insertion. If you have a hormonal IUD, you may find that your period is lighter or disappears. Other side effects can include: pelvic pain foul-smelling discharge abdominal pain unexplained fever headaches or migraine IUDs don't protect against sexually transmitted infections (STIs), so it's important to use a barrier method.
Scoop
09-07-2025
- Health
- Scoop
Cutting Red Tape To Improve Medicines Access
Associate Minister of Health Associate Health Minister David Seymour welcomes Pharmac's decision to improve access to asthma inhalers and long-acting contraceptives from 1 August 2025. 'For the first time, Pharmac has its own Minister. Last year I outlined in my letter of expectations that Pharmac should have appropriate processes for ensuring that people, along with their carers and family, can participate in and provide input into decision-making processes around medicines – this is committed to in the Act-National Coalition Agreement,' Mr Seymour says. 'Since then, the culture shift at Pharmac has been positive. It has moved towards a more adaptable and people-centered approach to funding medicines. My expectation is that this will continue.' Following a consultation period Pharmac has made decisions to: · Improve access to some strengths of budesonide with eformoterol inhalers. · Remove some of the barriers to Mirena and Jaydess intra-uterine devices (IUDs). 'From 1 August 2025 people will be able to get three-months supply of some budesonide with eformoterol inhalers all at once. Pharmac will also fund some budesonide with eformoterol inhalers on a Practitioners Supply Order (PSO), meaning doctors and nurses can keep some in their clinic for emergency use, teaching, and demonstrations,' Mr Seymour says. 'For the over 120,000 Kiwis using this type of inhaler the changes mean less visits to the pharmacy for resupply, better asthma management, and an extra option for supply in emergencies. 'Doctors and nurses will also be able to keep Mirena and Jaydess IUDs in their clinic and will be able to place them in the same appointment. Pharmac will fund these on a PSO to enable this. 'Current settings mean women need to get a prescription from their doctor or nurse, pick their IUD up from a pharmacy, and then bring it back to the clinic to be placed. Pharmac estimates over 21,000 women to benefit from these changes in just the first year of funding. 'People told Pharmac that these changes will make a real difference. They will make it easier for people with asthma to get the inhalers they need and improve access to long-acting contraceptives like Mirena and Jaydess. They make sense for people. 'People should have the opportunity to share what the impact of changes would be for them. 'The Government is doing its part. Last year we allocated Pharmac its largest ever budget of $6.294 billion over four years, and a $604 million uplift to give Pharmac the financial support it needs to carry out its functions - negotiating the best medical deals for New Zealanders.'
Scoop
09-07-2025
- Health
- Scoop
Pharmac To Improve Access To Asthma Inhalers And IUDs From 1 August 2025
Pharmac is making changes to improve access to some asthma inhalers and long-acting contraceptives from 1 August 2025. 'We're making it easier for people to get the medicines they need, when and where they need them,' says Pharmac's Acting Director Pharmaceuticals, Adrienne Martin. 'These changes will help over 140,000 New Zealanders in the first year alone.' From 1 August 2025, people using some strengths of budesonide with eformoterol inhalers will be able to receive three-months supply all at once, reducing the need for multiple pharmacy visits. Some budesonide with eformoterol inhalers will also be available on a Practitioners Supply Order (PSO). This means doctors and nurses will be able to keep it in their clinic for emergency use, teaching and demonstrations. They will also be able to give it to people if accessing a pharmacy isn't practical. 'These changes mean people can keep inhalers where they need them most – at home, work, or school – and learn how to use them correctly with support from their health care provider. 'People have told us these changes will make a real difference,' says Martin. 'That they support better asthma management and align with updated clinical guidelines.' Pharmac is also changing how IUDs and contraceptive implants are supplied. From Friday 1 August 2025, Mirena and Jaydess IUDs will be available on a Practitioners Supply Order (PSO), allowing doctors and nurses to provide them directly during appointments. Pharmac is also increasing the number of Jadelle contraceptive implants available on PSO, reducing the number of stock orders clinics need to make, helping to save time - especially those with high patient volumes. 'These changes will improve access for over 21,000 people in the first year and align IUD access with other long-acting contraceptives,' says Martin. 'People have told us that it will remove barriers, reduce delays, and allow for timelier and efficient care.'
