12. Short Debate: Endometriosis and the women’s health plan in Wales

Part of the debate – in the Senedd at 6:46 pm on 29 March 2023.

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Photo of Baroness Mair Eluned Morgan Baroness Mair Eluned Morgan Labour 6:46, 29 March 2023

Diolch yn fawr. I'm really grateful to Huw Irranca for introducing this incredibly important topic for the short debate today. I hope you get better, Huw. Thank you very much for highlighting the difficult cases that you have. I think it's absolutely right that it's not just women who are leading the charge on this—it's really important that men understand how this impacts on so many women's lives.

March is Endometriosis Action Month, and I welcome the opportunity to highlight the challenges women continue to face, and to reiterate my commitment to deliver changes to the way healthcare is provided here in Wales, because for too long there have been deep-seated and entrenched inequalities in the healthcare provided to women. These inequalities present themselves in a multitude of ways, including how women's experiences and concerns are viewed and symptoms acted upon. This is particularly so for issues and conditions exclusive to women.

Endometriosis is a chronic condition affecting one in 10 women. Whilst it's most commonly active from puberty to menopause, its impact can last for life. The exact cause of endometriosis is the subject of medical debate, but its effects are clear. It occurs where cells similar to the endometrial cells lining the womb are found elsewhere in the body, where they should not be. These cells continue to menstruate monthly, but there's no external flow, and that can cause inflammation, scar tissue, fertility issues and significant pain, which can at times be entirely debilitating, as we've heard.

For many women, endometriosis can be difficult to diagnose and can take years to be accurately identified and treated. Endometriosis effects women from all social and ethnic backgrounds, and whilst there are several common symptoms, the extent of the condition and the range of severity of its symptoms varies considerably between individuals. Sadly, despite the prevalence of endometriosis, evidence suggests that it takes on average nine years to receive a diagnosis in Wales. This often follows numerous visits to doctors and hospitals, during which symptoms may not be recognised, or in some circumstances are even dismissed. For many women, particularly those experiencing endometriosis symptoms from a young age, they may not realise that what they're experiencing is not normal. This first step of believing women, recognising and acknowledging severe menstrual pain as possible endometriosis, should lead to appropriate investigations without delay.

At the heart of discussions about waiting times, there are women who are often suffering in silence, whose lives are being profoundly impacted. Nothing illustrates this more than the experience of a women's health advocate who is supporting the work that we're taking forward, for which I'm truly grateful. It sounds very similar to the example you gave, Huw. I think you gave an example of 20 years. Well, it took this particular woman 23 years to receive an endometriosis diagnosis. Her symptoms and concerns were repeatedly dismissed by doctors as being the result of stress or of a low pain threshold. She was told her concerns were simply in her head and a product of depression and anxiety. Yet, despite these incorrect labels, no referral to mental health services took place. The severity of her symptoms and the uncertainty that resulted from a lack of appropriate clinical care and support had a significant impact on her personal life and almost resulted in her losing her job. That's one woman's experience, but it will sound very familiar to far too many women.

Women make up half the population, yet historically they've been disadvantaged by a lack of research and data about conditions, including endometriosis. This has constrained our collective understanding of the disease, our ability to quickly and conclusively diagnose its presence, as well as offer prompt and effective management and treatment. Endometriosis may be—