Diolch, Dirprwy Lywydd. I could open this debate by reeling off the statistics that clearly show the need for action on health inequalities and the reason why we have tabled this motion before Members today, and that the lack of a women's health strategy merits scrutiny and debate, especially given the Government's own stated aim of becoming a feminist Government. But I'll save my own words this afternoon and let others speak for me, because I want to share accounts and experiences of women who will put the case for our motion powerfully and overwhelmingly. In fact, giving them the platform of this Senedd Chamber, ensuring that we all hear their voices this afternoon, is vital. Because the sad truth is that the stigmatisation of women's health conditions such as endometriosis, menopause, polycystic ovary syndrome, premenstrual dysphoric disorder and others restrict conversation and isolate women when, in fact, they're experiences that should unite us and spur us into action. These voices are not heard, nor their pleas for more support, for the attention they deserve, for better treatment, because, historically, with limited investment in research into women's health in general, there's been so little research into conditions such as endometriosis that we don't even know what causes it. And without knowing the cause, a cure cannot, of course, be found.

Kate Laska from Gwynedd suffers from endometriosis. She had to travel outside of Wales to get specialist help and pay privately for treatment, after waiting years to get a diagnosis and even longer to get treatment. And she's still in chronic pain now. These are her words:

'Imagine that, for years, you live in a lot of physical pain. You try to get help but you are told that the pain you are feeling is normal. In the meantime, you lose your job, your income and your partner. After changing my doctor, I finally had my diagnosis, but I had no idea that, for the next seven years, I would spend fighting for my right to treatment. Due to very often suboptimal care and a lack of awareness amongst the healthcare workers as well as society, including myself, endometriosis in my case progressed to stage 4 and required numerous complex surgeries. Now imagine you do not find much support around you in times when you mostly need it, because there is a belief in society that women are destined to experience pain. Women with endometriosis suffer in silence and very often alone, because no-one around them can imagine their pain. There is only one specialist clinic in Cardiff where women like myself can hope for relief. However, this clinic is currently overwhelmed with patients. Time is crucial with this chronic condition. This is why there is an urgent need for a local service based in north Wales.'

The lack of investment in treatment for women's health conditions like endometriosis has resulted in cross-border agreements for treatment—for example, women like Kate, who live in north Wales, attend the endometriosis specialist centre in Liverpool. But this does not always happen. One of my own constituents, Becci Smart, has been living with PMDD, premenstrual dysphoric disorder, since the age of 14, but wasn't diagnosed with the condition until age 30. PMDD is a very severe form of premenstrual syndrome, which can cause a range of emotional and physical symptoms every month during the week or two before your period. In her own experience, and from the experiences of others she has spoken to with PMDD, she says that there is a severe lack of mental health support available and a lack of understanding of the condition among GPs. Indeed, she says that sufferers of PMDD are being turned away from mental health services, as they are incorrectly told that it's a purely gynaecological condition, rather than a mental health one. It is, of course, both these things. They are told instead to see their GPs, who are not experts on mental health, every time PMDD severely affects their mental health, which is a week or two every month.

Currently, there are no blood or saliva tests or scans to diagnose PMDD. The only way to diagnose it is to track symptoms alongside the menstrual cycle for at least two full months. There is no cure, only symptom management. Diagnosis takes, on average, 12 years and approaching, on average, six different healthcare professionals. This, while PMDD affects one in 20 menstruators of reproductive age, and those with PMDD are at a 7 per cent increased risk of suicide than those without premenstrual disorders. Seventy-two per cent have active suicidal ideation during every PMDD cycle. That's each menstrual cycle. Thirty-four per cent have made active suicide attempts during PMDD weeks. Fifty-one per cent have self-injured in a non-suicidal way during PMDD weeks. I'm sure we will hear many more of these harrowing accounts as part of Members' contributions this afternoon. I'm glad that our motion means they will be heard, because this suffering is inexcusable, because there can be no doubt that there is gender inequality at play here.

While women in Wales have a longer life expectancy than men, it is clear that they are spending less of their life in good health, and this arises from a lack of medical research into women's health, which means researchers do not have the opportunity to identify and study sex differences in diseases. And it creates assumptions that similar medical treatments will work for both males and females. For example, diabetes, heart attacks, autism are all conditions that can present differently for males and females. There's also still this pervasive belief in parts of the medical community that stems from societal patriarchy and, to some extent, misogyny, that when a woman complains about her health, it's either hormonal, emotional or irrational and is often framed around their reproductive functions as women.

There is a gender health gap that must be better addressed. Why else has there been five times the amount of research into male erectile dysfunction, which afflicts 19 per cent of men, than there has been into premenstrual syndrome, which affects 90 per cent of women? What else can explain why, when there are concerns that some women across the UK were unable to obtain their prescriptions due to shortages of HRT products two years ago, there was a failure to deal with the shortages? And this, coupled with the impact of COVID-related global supply problems, means around 1 million women in the UK, who use HRT to relieve the symptoms of menopause, will be affected, and so will many women in Wales who rely on this treatment.

It is vital that we address the failures within women's health, so that we can open up the conversation and change its constricted culture. To do this, the Welsh Government needs to develop a bespoke women's health strategy for Wales, which should focus on lifelong women's health; high-quality services, including specialist tertiary care; and investment in high-quality and enhanced training for healthcare professionals. I look forward to Members' contributions to this important debate, and I urge all Members to support the motion. We owe it to the women who have told us of their pain and frustration to listen and to act. Diolch.