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NICE guidelines on endometriosis

Portfolio politics

Louise Newson

Sunday, 10 September 2017

endometriosis_AdobeStock_126345857.jpgThe NICE guidance on the diagnosis and treatment of endometriosis has recently been published. Endometriosis affects around one in 10 women and it is the most common gynaecological disorder. However, our practice certainly does not have 10% of our female patients of reproductive age diagnosed with this condition and I suspect my GP practice is not unique in this.

The diagnosis of endometriosis if often delayed or even missed in women and also in adolescent girls. Many women have a delay in diagnosis of a decade which is unacceptable. This means that many women are often needlessly suffering with symptoms that are negatively affecting the quality of their lives.

As GPs, it is really important we have a low index of suspicion for this condition in women who present with chronic pelvic pain, dysmenorrhoea and/or deep pain during or after sexual intercourse.

Although investigations can be useful for some women to make a diagnosis, it is important that we do not exclude this diagnosis in women with a normal pelvic ultrasound scan. We should consider starting treatment, ideally with hormones, and then refer to a gynaecologist if this treatment is not effective.

Endometriosis is costing the UK economy a staggering £8.2 billion annually. Many women are needlessly suffering with prolonged, chronic pain caused by a progressive condition which can be more difficult to treat if not managed properly. Years of being told their symptoms are ‘normal’ or ‘in their heads’ can affect women mentally as well as physically.

This new NICE guidance provides a great opportunity to significantly reduce diagnosis times and also to improve endometriosis care. Better, quicker diagnosis and timely treatment is vital to enable women to lead productive lives, and reduce the huge variety of current practice and access to services across the UK. However, to deliver the promise of these guidelines there needs to be improved training and awareness by GPs, time allocated for necessary surgery and more resources available.

Dr Anne Connolly has recently been appointed as the RCGP clinical champion in Women’s Health. This is a new appointment and this role aims to raise the profile of women’s health needs by working alongside other stakeholders to develop a clinical spotlight programme in the first year. She is also the chairperson of the Primary Care Women’s Health Forum (PCWHF) which is a free-to-join organisation for clinicians working in primary and community care. It is dedicated to the education and support of healthcare professionals across the UK caring for female patients.  

Anne and the PCWHF will be working hard to improve the diagnosis and care of women with endometriosis and help clinicians to incorporate NICE guidance in their clinical practice.

Author's Image

Louise Newson

Louise is a part-time GP in Solihull, as well as a writer for numerous medical publications, including www.patient.info. She is an Editor and Reviewer for e-learning courses for the RCGP. She is an Editor for Geriatric Medicine journal and the British Journal of Family Medicine. Louise has contributed to various healthcare articles in many different newspapers and magazines and is the spokesperson for The Information Standard. She has also done television and radio work. Louise is a medical consultant for Maverick TV and has participated regularly in ‘Embarrassing Bodies Live from the Clinic’. Louise has three young children and is married to a consultant urological surgeon. Although her spare time is limited she enjoys practising ashtanga yoga regularly and loves road cycling – she has raised over £2K for a local charity, Molly Olly Wishes by competing in a 120km cycle ride!
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