Endometriosis — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 51 of 2021

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting endometriosis or death from endometriosis with the circumstances of a person's relevant service:

1. (1)
   having penetrating trauma or surgery involving the site of subsequent endometriosis before the clinical onset of endometriosis;
2. (2)
   having a caesarean section within the five years before the clinical onset of endometriosis;
3. (3)
   being underweight for a period of at least one year while aged 18 years or younger before the clinical onset of endometriosis;

   Note: being underweight is defined in the Schedule 1 - Dictionary.

4. (4)
   taking estrogen only menopausal hormone therapy for the three months before the clinical onset of endometriosis;

   Note: menopausal hormone therapy is defined in the Schedule 1 - Dictionary.

5. (5)
   taking tamoxifen for the six months before the clinical onset of endometriosis;
6. (6)
   for parous women only, inability to breast feed for a cumulative period of at least three months before the clinical onset of endometriosis;

   Note: The period of breastfeeding could be cumulative over a number of pregnancies.

7. (7)
   experiencing severe childhood abuse before the clinical onset of endometriosis;

   Note: severe childhood abuse is defined in the Schedule 1 - Dictionary.

8. (8)
   having pelvic inflammatory disease or endometritis before the clinical onset of endometriosis;
9. (9)
   taking estrogen only menopausal hormone therapy for the three months before the clinical worsening of endometriosis;

   Note: menopausal hormone therapy is defined in the Schedule 1 - Dictionary.

10. (10)
    taking tamoxifen for the six months before the clinical worsening of endometriosis;
11. (11)
    for parous women only, inability to breast feed for a cumulative period of at least three months before the clinical worsening of endometriosis;

    Note: The period of breastfeeding could be cumulative over a number of pregnancies.

12. (12)
    having pelvic inflammatory disease or endometritis before the clinical worsening of endometriosis;
13. (13)
    inability to obtain appropriate clinical management for endometriosis;

Aggravation-only factors: the factors in subsections 9(9) to 9(13) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.