The Primary Care Women’s Health Forum’s annual conference was recently held in Leeds. This is always a fantastic opportunity to meet like-minded colleagues and to learn new facts and update knowledge on various different women’s health topics.
During the evening before the conference, there was an informative educational meeting on different aspects of endometriosis. At the end of this, we all worked together to create a ‘10 tips on endometriosis’ guide, which are to be published on the PCWHF website.
Endometriosis is still poorly managed in the UK, and far too many women are needlessly suffering as a result of delayed diagnosis and inadequate treatment. Primary care doctors and nurses are well placed to help these women, but often need more training and education to improve endometriosis care.
Anne Connolly, chair of the PCWHF, opened the evening by giving a brief overview of the recently published NICE guidance. Dr Uma Marthi, aGPwSI in Women’s Health, spoke about the need for more research into endometriosis. Emma Cox, the CEO of Endometriosis UK, gave a very inspirational and powerful talk about the numerous ways in which the charity is working hard to improve awareness of this condition in school children and adults.
Then a patient representative for the charity gave a very emotional and poignant presentation about how having endometriosis had affected her personal and professional life. Listening to her speak made us all think about how difficult it must be to live with chronic pain and how important it is to have a supportive, caring doctor who really understands the disease and the patient’s needs.
The ‘10 Top Tips for Management of Endometriosis in Primary Care’ were produced after much collaboration between the GPs, nurses and gynaecologists who attended the meeting. They are based on the recent NICE guidance and provide simple, practical advice regarding the diagnosis and management of endometriosis in primary care. They are available on the PCWHF website (www.pcwhf.co.uk).
As healthcare professionals, we need to be more proactive in diagnosing and treating endometriosis. Currently, the average time for diagnosis is 7.5 years which is far too long and not acceptable. A recent survey has shown that a staggering 40% of women needed 10 GP appointments before having their diagnosis made.
There needs to be a holistic approach to managing these women, and they need to be given accurate information about their condition so they can make informed choices about their future management. Women need to be counselled about the unpredictable nature of their pain and also about how their pain and other symptoms can potentially affect future relationships. Care pathways following surgery should encompass expert advice about pain support, fertility issues, bowel and bladder problems. In addition, around a third of patients have depression and this needs to be diagnosed and managed appropriately.
As healthcare professionals, we should have a low index of suspicion for endometriosis in women who present with painful periods or cyclical pain of any nature. Starting treatment early will improve symptoms and can reduce future complications. Treatment should not be delayed while waiting for a secondary care appointment.
We’re delighted to include an excellent overview of the endometriosis guidelines in January’s issue of BJFM, and I urge everyone to read and assimilate the information. We should all be working hard to improve our knowledge about this common condition.