Australia’s drug advisory committee has recommended wider funding of triptorelin for women with breast cancer or endometriosis.

The recommendation comes after AstraZeneca announced plans to remove Zoladex from the market, risking leaving more than 7,500 women with breast cancer without an alternative treatment.

Both medicines block the release of oestrogen and testosterone and can be used as part of treatment, or for fertility preservation, in some forms of cancer.

The Pharmaceutical Benefits Advisory Committee met urgently in July and recommended making triptorelin unrestricted under the Pharmaceutical Benefits Scheme (PBS), which would mean it was funded for all uses.

The drug has been listed on the PBS for prostate cancer since 2006.

Triptorelin and Zoladex can also be used to treat endometriosis and to block puberty for either precocious puberty or gender-affirming care.

Vicki Durston, director of policy and advocacy at Breast Cancer Network Australia, described the recommendation as “a significant step forward” and said access to the medicine could mean the difference between life and death for some patients.

She said some women had already chosen to have their ovaries removed because of uncertainty over Zoladex supplies.

Marilla Druitt, Victorian state chair of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, said it remained unclear whether triptorelin would work exactly the same way as Zoladex, but the recommendation was likely to be positive for patients with endometriosis and pelvic pain.

She said: “I’m glad we’ve got an alternative.”

“That’s fantastic, and it remains to be seen whether or not it will be as good, but pain is so complex, pain is a really hard thing to study because it’s got so many contributors.”

Druitt said further research would be needed after the medicine was introduced.

If accepted by the federal government, the recommendation would also allow PBS funding of triptorelin for puberty suppression in precocious puberty and gender-affirming care.

This would make gender-affirming care federally funded through the PBS for the first time and would remove a financial barrier for transgender children in Queensland and the Northern Territory.

Stuart Aitken, medical director of Gender Health Australia, said the recommendation had sparked “absolute joy” among his patients.

He said: “It takes away a huge barrier to accessing evidence-based care.”

“It means that the ban has a very limited effect.”

Women later diagnosed with endometriosis used more antidepressant and anxiety medication than other women, with the pattern emerging years before diagnosis, recent study found.

The difference was evident up to 10 years before diagnosis and continued for a decade afterwards, according to a large Danish registry-based study involving 136,842 women.

Women with the condition also had substantially more contact with psychiatric hospital departments than those without it.

Researchers at Aarhus University found that women with endometriosis redeemed 29 per cent more prescriptions for antidepressants and 16 per cent more for anxiety medication in the years before diagnosis.

After diagnosis, the differences rose to 40 per cent for antidepressants and 46 per cent for anxiety medication.

Marie Josiasen, PhD student at the department of public health and one of the researchers behind the study, said: “What surprised us was how clear and persistent the pattern was, and that the difference did not diminish over time.

“On the contrary.

“Women with endometriosis consistently redeemed more prescriptions for antidepressant medication than women without the disease throughout the entire period, from ten years before to ten years after diagnosis.”

The study does not provide an answer as to what causes the mental strain.

Josiasen said prolonged pain, uncertainty about the cause of symptoms and fertility problems could be among the factors contributing to psychological strain.

She said: “It’s possible that prolonged pain, uncertainty about the cause of the symptoms, and frustration over not being able to live the life one wants may be among the reasons. For some women, fertility problems can also be a major psychological burden.”

Researchers also found that the gap compared with women without endometriosis did not narrow after diagnosis. Instead, it became more pronounced in the years that followed.

Josiasen said: “A diagnosis can be a relief, but it also involves coming to terms with having a chronic illness.”

The study does not indicate whether diagnosing endometriosis earlier could reduce psychological strain.

As part of her PhD project, Josiasen will investigate the role hormonal contraception may play in the mental health of women with endometriosis.

She said: “We can see that many receive medication and are in contact with psychiatric services. But we still lack an understanding of what actually helps these women.

“That’s what I want to help find out.”

Two endometriosis tests could cut years from diagnosis after NICE backed their temporary NHS use in England and Wales.

EndoSure and Endotest have been recommended in draft guidance, with one able to provide results in 45 minutes.

Endometriosis affects around one in 10 women of reproductive age. It occurs when tissue similar to the womb lining grows elsewhere, including around the ovaries and fallopian tubes.

Symptoms can include painful periods, painful bowel movements, pain when urinating and pain during or after sex.

Diagnosis can involve ultrasound scans, magnetic resonance imaging (MRI) or laparoscopy. A laparoscopy is keyhole surgery in which a camera is inserted through a small cut in the abdomen.

Despite the effect the condition can have on physical and mental health, women can wait years for a diagnosis.

The average wait in the UK is nine years and four months, rising to 11 years for women from ethnically diverse communities, according to the National Institute for Health and Care Excellence (NICE).

Long waits can increase suffering, prolong poor health and allow the condition to progress, making it more difficult to treat.

Dr Anastasia Chalkidou, NICE’s healthtech programme director, said: “A diagnosis of endometriosis can for some women take the best part of a decade, with the UK average standing at nine years and four months, and rising to 11 years for those from ethnically diverse communities.”

She said delays could lead to chronic pain affecting daily life, relationships and work.

She added: “These technologies have the potential to change that by giving primary care professionals better non-invasive tools to identify endometriosis earlier, allowing earlier and better treatment.

“Our draft guidance reflects our commitment to getting promising innovations to patients quickly, while making sure the evidence to support their wider use is built in a rigorous way.”

Endotest examines a saliva sample for microRNAs, tiny biological markers that can indicate the presence of endometriosis.

The sample is sent to a laboratory and the result returned to a GP or another healthcare professional to inform the next steps in diagnosis and care.

EndoSure uses sensor pads placed on the abdomen to measure electrical signals in the gut.

Women must fast for between six and eight hours before the 45-minute test. During the procedure, they drink water until they feel full, helping the device record gut activity accurately.

Results are available as soon as the test is complete.

The draft recommendation, published on Tuesday, approves both technologies for three years while further evidence is collected on how well they work.

NICE will then decide whether to approve them permanently for NHS use.

NICE said a third test, DotEndo, needs more research before it can be recommended.

EndoSure and Endotest are not designed to diagnose the condition on their own.

They are intended for women whose symptoms still suggest endometriosis after a normal clinical examination and negative or inconclusive imaging results, or when imaging has not been carried out.

Dr Gail Busby, a consultant gynaecologist at Manchester University NHS Foundation Trust, said: “These tests are a gamechanger because they give us answers much earlier, without the need for invasive surgery, and that means we can start the right treatment sooner.

“An earlier diagnosis doesn’t just change one person’s life, it frees up appointments and surgical slots for everyone waiting for care.”

Emma Cox, of Endometriosis UK, welcomed the tests.

She said their introduction should be supported by education for GPs and nurses to ensure prompt access and prevent symptoms from going unrecognised.