‘Medical misogyny’ leading to years of gynaecological pain

The Women and Equalities Committee (WEC) recently highlighted that women with reproductive health issues such as endometriosis, adenomyosis, and heavy menstrual bleeding often have their symptoms dismissed due to a lack of awareness. Endometriosis, affecting 10% of women in the UK, causes chronic pelvic pain and painful periods due to tissue similar to the uterine lining growing outside the uterus. Adenomyosis involves the uterine lining growing into the muscular wall of the uterus, also causing pain.

The report notes that these conditions are common in the UK, but diagnosis and treatment can take years, leading to prolonged suffering that impacts daily life, including education, careers, relationships, and fertility. Many women resort to expensive private healthcare. The Royal College of Obstetricians and Gynaecologists has identified a 'gynaecology care crisis' with over 750,000 women waiting for treatment.

The report attributes this to stigma, insufficient education, and 'medical misogyny,' resulting in a lack of awareness, research, treatment options, and specialists. This is reflected in the growing waiting lists for gynaecological care.

A significant knowledge gap among primary healthcare providers, especially regarding young women and girls, was identified. The report urges the NHS to implement a training program to improve diagnosis and treatment experiences. Early diagnosis and follow-up appointments are crucial to prevent worsening symptoms.

The report suggests that diagnosis times should be a key performance measure for the Women's Health Strategy for England, noting slow progress since its 2022 release due to a lack of planning and resources. It also highlights that stressed healthcare practitioners lack sufficient knowledge of treatment options for reproductive health conditions. The NHS should ensure practitioners are informed about all diagnostic and treatment options and that patients are aware of their choices.

The Department of Health and Social Care (DHSC) is urged to improve access to professional development in women's reproductive health for primary care practitioners by increasing funding and providing protected training time. Making obstetrics and gynaecology mandatory in training is recommended to encourage specialisation. MPs noted gaps in teaching menstrual health in Relationships, Sex and Health Education (RSHE), with many girls leaving school without understanding normal menstrual health or recognising symptoms of reproductive conditions. The report calls for better training for teachers on gynaecological health, starting education when girls first experience menstruation, and suggests that boys also be educated on female reproductive health, including intersectional differences.

The report highlights the need for the NHS and other trustworthy sources to be the main points of contact for women and girls seeking help online to prevent misinformation. It emphasizes that the NHS's website, app, and social media channels need to be accessible, inclusive, and highly visible.

The document also addresses the intense pain some women endure during common healthcare procedures like hysteroscopy, IUD insertion, and cervical screening. It urges the NHS to improve oversight and enforcement of protocols for these procedures, ensuring they are conducted with informed consent, are trauma-informed, and consider the patient's medical history and experiences. Additionally, it recommends that the NHS gather data on adherence to guidelines for potentially painful gynaecological procedures, including patient feedback.

The report suggests that expanding the women's health hub model could significantly improve integrated care and support for women with reproductive health conditions. It calls for the Government to allocate long-term, ring-fenced funding and resources to develop this model, including increasing ultrasound facilities for better diagnosis. The Committee notes that increased funding for gynaecology has shown substantial returns on investment. The WEC also recommends more research funding to explore the causes, diagnosis, and treatment of women's reproductive health issues. While more funding will attract researchers, NHS England and research bodies should also find ways to boost interest in clinical academia. The report urges the Government to commit to reducing endometriosis diagnosis waiting times to under two years by the end of this Parliament and to improve the understanding and treatment of heavy menstrual bleeding.