pharmafile | July 7, 2025 | Feature | Research and Development | NHS, Obstetrics & Gynaecology, Pain, Reproductive health, Theramex, endometriosis, gynaecology
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By Tina Backhouse, General Manager, Theramex
When did we decide it was an acceptable condition of womanhood in the UK to live with chronic pain? 1
Endometriosis is a condition which causes cells that line the uterus to grow elsewhere and often causes complications, such as fertility issues. Most notably, women with endometriosis can experience excruciating pains around their menstrual cycle.2
There are 1.5 million women in the UK affected by endometriosis3 and yet too often it seems that healthcare professionals see severe period pain as a natural part of a woman’s cycle, rather than as an indication that something might not be right.4
There are currently three-quarters of a million women’s health appointments waiting to happen in the UK.5 How many of these are linked to women suffering from chronic pain, still waiting for answers?
Waiting for the ‘right’ GP
While public awareness of these once-taboo gynaecological conditions is growing, there is still room for greater engagement and understanding within the healthcare community.
The average wait for an endometriosis diagnosis is eight years,6 during which, women too often face misunderstanding and dismissal from medical professionals,1 leading to delays in treatment and multiple visits to A&E.7 Additionally, Black women are 50% less likely to be diagnosed with endometriosis than White women, and those who are diagnosed wait on average two and a half years longer than White women for their diagnosis.8
The workload of GPs is undeniably heavy, but it is crucial that time is taken, and training is completed to shift the perception of women’s pain. Misdiagnosing women’s pain as anxiety, or dismissing it as normal, must stop being a default response from so many GPs.1
The advice and guidance scheme, which connects GPs with hospital doctors to bypass lengthy waiting lists, is making progress by directing women towards specialist support via services such as women’s health hubs – local centres which integrate services to support women with gynaecological concerns. From July – December 2024, the scheme diverted 660,000 treatments (of all kinds, not just women’s health) from hospitals into the community.9
However, the advice and guidance scheme is only as good as the specialist support services that it has access to, and women’s health targets for Integrated Care Boards have since been scrapped.This means that that funding for these hubs could be redirected, leaving access to specialist endometriosis care in an even worse predicament.
It’s worrying that the gynaecological care waiting list backlog hasn’t had the necessary reaction; with these funding targets removed, it could lead to women continuing to wait on lengthy lists for appointments and relying more on the non-specialist, secondary care advice from GPs, who have no required training in women’s health.1
Paywalls to treatment
For many women experiencing debilitating endometriosis symptoms, the alternate ending to their stories is turning to private healthcare for diagnosis or treatment and, in some cases, even crowdfunding their treatments.10 Access to women’s health hubs is already a postcode lottery;11 we cannot allow this to be exacerbated by waiting lists creating a paywall to treatment.
The importance of women living without pain must not be sidelined by an overstretched NHS. Gynaecological conditions are often forgotten at the bottom of the pile; when living with endometriosis, the pain that many women experience is important, and the NHS must be better at attending to these significant cases with the same urgency that they provide to other conditions.1
Now is the time for doctors to recognise and address the severe pain many women endure during their periods.
Addressing these issues is not only vital for women’s health but also for the broader economic impact. The economic cost of absenteeism due to severe period pain and heavy periods alongside endometriosis costs the economy £11 billion due to absenteeism from work.12 Additionally, Endometriosis UK estimates that one in six women with endometriosis leave the workplace due to their symptoms.13 Ensuring women receive timely and effective care for conditions like endometriosis is crucial, not only for their well-being, but also to prevent the personal and economic toll that results from inadequate support.
GPs, as the first point of care, must understand women’s pain better. They need access to information and training around recognising gynaecological conditions, such as endometriosis, that can heavily impact the quality of women’s lives.1
For too long, women’s pain has been ignored
We shouldn’t leave it to chance whether a patient seeking support will be directed towards a GP with an understanding of endometriosis or not. It must become a government priority to ensure that GPs know what is and isn’t ‘normal’ for women to experience during their period, so that pain is no longer dismissed as part of the female experience.
References
1 Women and Equalities Committee. ‘Women’s reproductive health conditions.’ House of Commons Available at: https://committees.parliament.uk/publications/45909/documents/228040/default/ [Accessed May 2025]
2 Endometriosis UK, What is endometriosis?, Available at: https://www.endometriosis-uk.org/what-is-endometriosis. [Accessed May 2025]
3 Endometriosis UK, Endometriosis Facts and Figures, Available at: https://www.endometriosis-uk.org/endometriosis-facts-and-figures. [Accessed May 2025]
4 Wiggleton-Little Ja (2024), ‘“Just” a painful period: A philosophical perspective review of the dismissal of menstrual pain,’ Women’s Health Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11113068/. [Accessed May 2025]
5 Mundasad Sm et al (2024), ‘Gynaecology waiting lists double, leaving women in pain.’ BBC News Available at: https://www.bbc.co.uk/news/articles/clyvg2157mvo#:~:text=Waiting%20lists%20for%20gynaecology%20appointments%20across%20the%20UK,-%20up%20from%20360%2C400%20just%20before%20the%20pandemic. [Accessed May 2025]
6 Rajesh Sh et al (2025), ‘Diagnosis and management of endometriosis.’, BMJ 2025;388:q2782 doi:10.1136/bmj.q2782
7 Endometriosis UK (2024), ‘“Dismissed, ignored and belittled” The long road to endometriosis diagnosis in the UK’ Available at: https://www.endometriosis-uk.org/sites/default/files/2024-03/Endometriosis%20UK%20diagnosis%20survey%202023%20report%20March.pdf [Accessed May 2025]
8 Griffith Ve et al (2023), ‘Endometriosis: black women continue to receive poorer care for the condition’ The Conversation Available at: https://theconversation.com/endometriosis-black-women-continue-to-receive-poorer-care-for-the-condition-200663 [Accessed May 2025]
9 Department of Health and Social Care (2024), ‘Patients get care closer to home as GP scheme expanded.’ Gov.uk Available at:https://www.gov.uk/government/news/patients-get-care-closer-to-home-as-gp-scheme-expanded [Accessed May 2025]
10 McCarron Sa (2025), ‘Health service ‘failing’ endometriosis sufferers, says Northern Ireland mum fund raising for surgery.’ ITV News Available at: https://www.itv.com/news/utv/2025-01-20/mum-no-choice-but-to-head-abroad-for-surgery [Accessed May 2025]
11 Dimsdale Co (2024), ‘The six NHS regions without a women’s health hub, mapped.’ INews Available at:
https://inews.co.uk/news/nhs-regions-womens-health-hub-3439518#:~:text=Women%20face%20a%20postcode%20lottery%20of%20access%20to,England%20lacking%20a%20single%20dedicated%20women%E2%80%99s%20health%20hub. [Accessed May 2025]
12 NHS Confederation (2024), ‘Women’s health economics: investing in the 51 per cent.’ Available at: https://www.nhsconfed.org/publications/womens-health-economics[Accessed May 2025]
13 Endometriosis UK. ‘Endometriosis in the workplace.’ Available at: https://www.endometriosis-uk.org/endometriosis-workplace [Accessed May 2025]