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Editorials

Restructuring endometriosis care

BMJ 2024; 387 doi: https://doi.org/10.1136/bmj.q2416 (Published 18 November 2024) Cite this as: BMJ 2024;387:q2416
  1. Prathiba M De Silva, clinical lecturer in obstetrics and gynaecology1,
  2. Sharon Dixon, NIHR doctoral research fellow2,
  3. Ginisha Vekaria, workplace menstrual wellbeing programme manager3
  1. 1University of Birmingham, Birmingham, UK
  2. 2Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  3. 3Endometriosis UK, London, UK
  4. Correspondence to: P M De Silva [email protected]

Women need better coordination between primary and secondary care

Endometriosis affects as many as 10% of women of reproductive age, or 190 million women globally.1 It can cause debilitating chronic pelvic pain and infertility, with treatment, work loss, and healthcare estimated to cost £12.5bn annually in the UK alone.2 The 2024 National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report audited the care provided to 941 patients with surgically confirmed endometriosis and included the review of data from 120 general practitioners (GPs) and 623 specialists, alongside organisational data from 167 hospitals.3 The report highlights examples of effective, timely, holistic, and patient centred care across all settings but also reminds us that we could and should do better for many women with endometriosis, throughout their care journey. Specific challenges discussed include the long timeframe to and difficulties in diagnosing and treating endometriosis, the lack of coordination between primary and secondary care, and the difficulty in accessing supportive services.

No clinical findings specifically correlate with a diagnosis of endometriosis, so GPs must often consider other conditions that have similar presenting symptoms. This may …

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