Chamber
Plenary, 28 Jun 2001
28 Jun 2001 · S1 · Plenary
Item of business
Endometriosis
I start, of course, by congratulating Annabel Goldie on securing this important debate. This is a subject that receives very little recognition and I believe that it is an issue of discrimination against women in the health service. I do not want to dispute Annabel's figures, but a figure provided by Women's Health estimates that as many as 10 per cent of women suffer from the condition. Given the lack of diagnosis by GPs and the lack of knowledge about the condition among women, I suspect that the figure could be substantially higher.
I was aware of the condition before, but became even more aware of it because I have two friends who are suffering from it. What is the condition? It is thought to be the second most common gynaecological condition, and it is one of the most complex. It is a painful, chronic disease that affects many women during their reproductive years. The endometrium is the tissue lining the uterus. In response to hormonal commands, it builds up, breaks down and is shed every month, during menstruation.
With endometriosis, the tissue is found outside the uterus, in different locations. It still develops and continues to respond to the same hormonal commands, but, unlike with periods, the blood and tissue has nowhere to go. That can cause internal bleeding, inflammation, the formation of scar tissue and adhesions. That in turn can cause extreme pain, bladder and bowel problems and infertility.
Some women experience no pain or symptoms and their problems can be recognised only because of infertility investigations or during other surgery. However, for many women, the pain is absolutely intolerable. There are a number of symptoms, but endometriosis can be conclusively diagnosed only by a laparoscopy, as Annabel Goldie pointed out. Its causes are unknown and there is no known cure. Various types of treatment are available, ranging from hormone treatment to surgery, but, unfortunately, hormone treatment can cause side effects, including temporary infertility. Some women have found alternative therapies helpful, but unfortunately there has been very little research to demonstrate their effectiveness.
Various theories have been advanced about the causes of endometriosis. Suggested causes include genetic predisposition and retrograde menstruation. One very disturbing theory is that environmental toxins may be involved. Studies have shown that certain environmental toxins, such as dioxin and petrochemicals, can exacerbate endometriosis. More work needs to be done on that theory.
We do not know the cause of endometriosis, there is no cure and diagnosis often takes years—years of pain, suffering and mental anguish for some women. I mentioned my two friends who are suffering from this condition. Both are young women in their early 30s. One of them, May, was fobbed off for years by her GP, who told her that she probably had irritable bowel syndrome. After suffering unbelievable pain and discomfort, she moved to England and signed on with a female GP, who immediately diagnosed endometriosis. Within six months she had the surgery to which Annabel Goldie referred—a laparotomy—and her condition is now much improved. She told me that the relief of knowing what was wrong was unbelievable, as she had been convinced that there was something terminally wrong with her.
In retrospect, it is easy to think that May could have been more assertive with her original GP, but it is hard for women to tell GPs how to do their job. Women know their bodies; they know when something is far wrong, but they are at the mercy of their GPs. Too many GPs—particularly male ones—fob women off by saying that they are just experiencing what women have to go through every month. Worse, they consider them to be hysterical females with a low pain threshold.
In Scotland, the average time for diagnosis of endometriosis is seven years, which is absolutely shocking. The minister must consider ways of changing that. We must reduce delays in diagnosis by ensuring that GPs are better informed about this condition and able to recognise it. Like Annabel Goldie, I ask the minister to commit himself to a publicity campaign to raise awareness of endometriosis among GPs and among women. He should use his influence to ensure that endometriosis is included in GP training. He could also commit himself to encouraging GP specialists in this area. A national strategy could include a campaign to publicise the disease, better and quicker diagnosis, research into the causes of endometriosis, development of better ways of managing it and, ultimately, a cure. There must be resourcing of services to provide support to women and their families.
Physical pain and suffering is not the only way in which endometriosis affects women's lives. It can also mean infertility. There is a postcode lottery not only when it comes to diagnosis and treatment of endometriosis—the same applies to assistance with infertility treatment. That is another issue we need to address.
We must put an end to the shocking treatment of many women with endometriosis. We need recognition, diagnosis, research and sympathetic treatment of women by the health service. We need resources to ensure that those things are available and to support the societies and groups that help the women affected. Given that the Minister for Finance and Local Government has announced extra money today, this may be a good day to highlight the needs of women with endometriosis. Perhaps the Deputy Minister for Health and Community Care can press for some of that money to be used to tackle this horrendous disease.
I was aware of the condition before, but became even more aware of it because I have two friends who are suffering from it. What is the condition? It is thought to be the second most common gynaecological condition, and it is one of the most complex. It is a painful, chronic disease that affects many women during their reproductive years. The endometrium is the tissue lining the uterus. In response to hormonal commands, it builds up, breaks down and is shed every month, during menstruation.
With endometriosis, the tissue is found outside the uterus, in different locations. It still develops and continues to respond to the same hormonal commands, but, unlike with periods, the blood and tissue has nowhere to go. That can cause internal bleeding, inflammation, the formation of scar tissue and adhesions. That in turn can cause extreme pain, bladder and bowel problems and infertility.
Some women experience no pain or symptoms and their problems can be recognised only because of infertility investigations or during other surgery. However, for many women, the pain is absolutely intolerable. There are a number of symptoms, but endometriosis can be conclusively diagnosed only by a laparoscopy, as Annabel Goldie pointed out. Its causes are unknown and there is no known cure. Various types of treatment are available, ranging from hormone treatment to surgery, but, unfortunately, hormone treatment can cause side effects, including temporary infertility. Some women have found alternative therapies helpful, but unfortunately there has been very little research to demonstrate their effectiveness.
Various theories have been advanced about the causes of endometriosis. Suggested causes include genetic predisposition and retrograde menstruation. One very disturbing theory is that environmental toxins may be involved. Studies have shown that certain environmental toxins, such as dioxin and petrochemicals, can exacerbate endometriosis. More work needs to be done on that theory.
We do not know the cause of endometriosis, there is no cure and diagnosis often takes years—years of pain, suffering and mental anguish for some women. I mentioned my two friends who are suffering from this condition. Both are young women in their early 30s. One of them, May, was fobbed off for years by her GP, who told her that she probably had irritable bowel syndrome. After suffering unbelievable pain and discomfort, she moved to England and signed on with a female GP, who immediately diagnosed endometriosis. Within six months she had the surgery to which Annabel Goldie referred—a laparotomy—and her condition is now much improved. She told me that the relief of knowing what was wrong was unbelievable, as she had been convinced that there was something terminally wrong with her.
In retrospect, it is easy to think that May could have been more assertive with her original GP, but it is hard for women to tell GPs how to do their job. Women know their bodies; they know when something is far wrong, but they are at the mercy of their GPs. Too many GPs—particularly male ones—fob women off by saying that they are just experiencing what women have to go through every month. Worse, they consider them to be hysterical females with a low pain threshold.
In Scotland, the average time for diagnosis of endometriosis is seven years, which is absolutely shocking. The minister must consider ways of changing that. We must reduce delays in diagnosis by ensuring that GPs are better informed about this condition and able to recognise it. Like Annabel Goldie, I ask the minister to commit himself to a publicity campaign to raise awareness of endometriosis among GPs and among women. He should use his influence to ensure that endometriosis is included in GP training. He could also commit himself to encouraging GP specialists in this area. A national strategy could include a campaign to publicise the disease, better and quicker diagnosis, research into the causes of endometriosis, development of better ways of managing it and, ultimately, a cure. There must be resourcing of services to provide support to women and their families.
Physical pain and suffering is not the only way in which endometriosis affects women's lives. It can also mean infertility. There is a postcode lottery not only when it comes to diagnosis and treatment of endometriosis—the same applies to assistance with infertility treatment. That is another issue we need to address.
We must put an end to the shocking treatment of many women with endometriosis. We need recognition, diagnosis, research and sympathetic treatment of women by the health service. We need resources to ensure that those things are available and to support the societies and groups that help the women affected. Given that the Minister for Finance and Local Government has announced extra money today, this may be a good day to highlight the needs of women with endometriosis. Perhaps the Deputy Minister for Health and Community Care can press for some of that money to be used to tackle this horrendous disease.
In the same item of business
The Presiding Officer (Sir David Steel):
NPA
The final item of business today is a members' business debate on motion S1M-1970, in the name of Miss Annabel Goldie, on endometriosis.
Motion debated,
That the Parliament notes the debilitating effect which endometriosis has upon many women in Scotland; acknowledges the need for greater awareness of this di...
Miss Annabel Goldie (West of Scotland) (Con):
Con
I have pleasure in opening the debate on the motion in my name. I thank colleagues for supporting the motion and for being present. In particular, I thank th...
Elaine Smith (Coatbridge and Chryston) (Lab):
Lab
I start, of course, by congratulating Annabel Goldie on securing this important debate. This is a subject that receives very little recognition and I believe...
Mr Kenneth Gibson (Glasgow) (SNP):
SNP
I congratulate Annabel Goldie on securing this debate. I also congratulate her and Elaine Smith on their passionate and informed speeches.As I have a mother,...
Mary Scanlon (Highlands and Islands) (Con):
Con
I, too, would like to thank Annabel Goldie for initiating this debate. Like her, I can barely pronounce the condition, let alone understand it—and even less ...
Elaine Smith:
Lab
Does Mary Scanlon agree that it is unacceptable that some health boards will help with fertility treatment and that others will not? Strangely, women who liv...
Mary Scanlon:
Con
The passion with which Elaine Smith speaks on this subject has been mentioned. I advise her that women from Wick and Skye in the Highland Health Board area m...
The Deputy Minister for Health and Community Care (Malcolm Chisholm):
Lab
I congratulate Annabel Goldie on obtaining today's debate, which will help to raise the profile of endometriosis in Scotland. The timing of the debate is app...
The Deputy Presiding Officer (Mr George Reid):
SNP
That concludes this debate on endometriosis. To those who are now heading off, I wish you happy holidays.
Meeting closed at 17:36.