Women and Equalities Committee: Women’s reproductive health conditions (11 December 2024)

Summary

Women’s reproductive health conditions, such as endometriosis, adenomyosis and heavy menstrual bleeding are highly prevalent in the UK. This report looks at the experiences of care women with reproductive conditions get in England. It states that many women find their symptoms dismissed and normalised by those they turn to for help. For some conditions, it highlights that accessing diagnosis and treatment can take years, leaving patients to endure pain that interferes with every aspect of their daily lives, while their conditions worsen.

Content

Key issues highlighted in this report include:

• Pervasive stigma associated with gynaecological and urogynaecological health, a lack of education and “medical misogyny” has contributed to poor awareness of these conditions.
• Diagnosis is slow not only because reproductive health conditions often have non-specific symptoms, but because of a lack of expertise and resource.
• Women continue to undergo harrowing experiences of painful procedures such as hysteroscopy and having a contraceptive coil fitted. This includes not being informed of the potential pain, feeling they cannot stop procedures and not having access to sufficient pain relief. This is against medical best practice and guidelines.
• Women’s health hubs are being established across integrated care boards as part of the previous Government’s Women’s Health Strategy for England. The model has the potential to be a positive step towards providing the joined-up care and commissioning needed to support women with reproductive health conditions but it requires funding to do so effectively.
• Research into women’s reproductive health conditions lags behind other, similarly prevalent conditions. It is not adequately prioritised by funders or commissioners and is not incentivised enough in clinical academia.
• Although there are patches of progress since the Women’s Health Strategy for England published in 2022, it has been too slow. The strategy lacks an implementation plan and resource, yet studies show that increases in funding for gynaecology services for early diagnosis and treatment provide a significant return on investment, reduces the burden on primary and secondary care settings and helps reduce sick leave and unemployment.

The report makes a wide range of recommendations relating to the following areas:

• Public understanding of reproductive health conditions.
• Accessing diagnosis.
• Accessing treatment and support.
• Training and standards.
• Research into women’s reproductive health conditions.

In relation to the Women’s Health Strategy for England, it recommends that:

• This should be updated to include priorities for specific, common conditions. 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, diagnosis and treatment of heavy menstrual bleeding over the same period.
• The Government should allocate increased, ringfenced 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.
• The Government should publish an implementation plan for the Women’s Health Strategy for England detailing timelines, costs and resource.

Related reading

• Failures of informed consent and the impact on women’s health: a Patient Safety Learning blog
• Hysteroscopy: 6 calls for action to prevent avoidable harm
• Medicines, research and female hormones: a dangerous knowledge gap
• One hour with a women's health expert and finally I felt seen
• The normalisation of women’s pain
• Sex bias in pain management decisions
• Misogyny is a safety issue: a blog by Saira Sundar
• Dangerous exclusions: The risk to patient safety of sex and gender bias
• Unconscious bias: gynaecological pain, the elephant in the womb!
• Pain bias: The health inequality rarely discussed