Women's pain 'dismissed' in UK, warns parliamentary report
Government asked to more funding, research and training for healthcare professionals
Women in the UK experiencing painful reproductive health conditions such as endometriosis, adenomyosis and heavy menstrual bleeding are frequently finding their symptoms ‘normalised’ and their ‘pain dismissed’ when seeking help, a new report by the Women and Equalities Committee (WEC) has warned.
While conditions are highly prevalent in the UK, accessing diagnosis and treatment can take years, leaving women and girls to “suck it up” and endure pain and discomfort that interferes with every aspect of their daily lives, including their education, careers, relationships and fertility, while their conditions worsen. Many are resorting to expensive private healthcare, it added.
The WEC, which produced the report, is appointed by the House of Commons to examine the work of the Government Equalities Office (GEO). It holds Government to account on equality law and policy.
Chair of the WEC and Labour MP Sarah Owen said:
“Our inquiry has shown misogyny in medicine is leaving women in pain and their conditions undiagnosed. Women are finding their symptoms dismissed, are waiting years for life changing treatment and in too many cases are being put through trauma-inducing procedures. All the while, their conditions worsen and become more complicated to treat
“This report must act as a wake-up call and the NHS must urgently implement a training programme to improve the experience of treatment and diagnosis of reproductive health conditions.”
Urgent gaps to fill
The report highlights urgent gaps to fill in women’s healthcare in the UK including:
Pervasive stigma associated with gynaecological and urogynaecological health
‘medical misogyny’ which has contributed to poor awareness of these conditions
“clear lack of awareness and understanding of women's reproductive health conditions among primary healthcare practitioners”, particularly when those conditions occur in young women and girls
a lack of progress since the Women’s Health Strategy for England was published in 2022 - with a lack of an implementation plan and resource.
The report says that these findings are mirrored in a lack of medical research, treatment options, specialists, and the de-prioritisation of gynaecological care as evident by waiting lists, which have grown faster than any other specialty in recent years.
Women’s health must be prioritised
The report makes a number of clear recommendations:
More training: It calls on the NHS to “urgently implement a training programme to improve the experience” of accessing treatment and diagnosis for women and girls with reproductive ill health. The NHS must take steps to ensure practitioners keep up to date with the full range of diagnostic and treatment options available for reproductive health conditions, and that patients understand their options. The Government should also consider how to better incentivise healthcare professionals to specialise in women's reproductive health, including making obstetrics and gynaecology a mandatory rotation in training.
Better education in schools: the teaching of the menstrual health element of relationships, sex and health education (RSHE) is “insufficient and inconsistent”, often delivered too late to be of use. It found that girls are leaving school not knowing what constitutes a ‘normal’ period, unequipped to spot the symptoms of reproductive health conditions. The report called on the Government to ensure teachers tasked with the menstrual and gynaecological health element of RSHE receive the training necessary to deliver it effectively and that information should be taught around the time most girls first experience menstruation. Statutory guidance, it added, should specify that boys be taught about female reproductive health conditions and include intersectional differences.
More trusted online information: Many women and girls, the report cautioned, are using online spaces to seek help. It is therefore imperative, the report concluded, that the NHS and trusted sources become a first port-of-call to prevent misinformation and that the NHS website, app and social media presence must be comprehensive, accessible, inclusive, and highly-visible.
Better monitoring of routine healthcare procedures: The report cited the severe pain experienced by some women undergoing routine healthcare procedures such as hysteroscopy, IUD fitting and cervical screening. It called on the NHS to do more to monitor and enforce protocols governing such procedures and ensure they are underpinned by informed consent, are trauma-informed and take account of a patient’s medical history and related experience. The NHS, it added, should collect data on whether guidelines for potentially painful gynaecological procedures are being adhered to, including patients’ experiences.
Long-term, ring-fenced funding and resource for the women’s health hub model: The expansion of the women's health hub model has the potential to be a positive step towards providing the joined-up care and commissioning needed to effectively support women experiencing reproductive health conditions, the report said. It found that women’s health hubs have proven the concept that they can deliver improvements to women’s healthcare. However, the report adds thqat the Government must now allocate long-term, ring-fenced funding and resource to embed and develop the hub model, including increased provision of ultrasound facilities that can aid diagnosis. In calling for more funding the Committee notes studies which have shown that increases in funding for gynaecology provide a significant return on investment.
Greater investment in research funding: WEC recommended the Government should allocate a greater share of research funding to support research into the causes, diagnosis and treatment of women's reproductive health conditions. While increased funding will in itself attract more researchers to this area, NHS England and research bodies should also consider what steps they can take to increase interest among clinical academia, it added. The report recommended the Government commits to reducing waiting times for an endometriosis diagnosis to less than two years by the end of this Parliament and to improved understanding and treatment of heavy menstrual bleeding over the same period.
Sarah Owen continued:
“Improving early diagnosis, including follow-up appointments, should be a key performance indicator for the Women’s Health Strategy for England. Individuals with a suspected or diagnosed reproductive health condition should be offered specialist mental health support.
“The Committee calls on the Government to recognise the financial benefits of increased investment in early diagnosis and treatment of women's reproductive health conditions and provide the additional funding necessary to truly transform the support available to the millions of women affected by reproductive ill health in this country.”
NHS must keep pace with FemTech
During the call for evidence for the report Dr Sue Mann, National Clinical Director for Women’s Health at NHS England said that the NHS needed to “get better” at producing its own digital information and to “start keeping pace” with existing women’s health apps in FemTech. The report said that this work is ‘urgent’ with the rise of femtech, such as period-tracking or fertility monitoring apps, some of which it says ‘may present a risk to women, especially in areas of data protection.’