Community pharmacists need better education about endometriosis given that pharmacies are often the first port of call for many experiencing symptoms, a national charity has suggested.

In a new report, Endometriosis UK called on professional bodies to provide more education about endometriosis and menstrual health for community pharmacists and other healthcare professionals.

A survey undertaken by the charity in 2023 found that the average time taken to diagnose the condition had increased by more than 10 months since 2020.

But suspecting endometriosis early could speed up diagnosis and improve outcomes for patients, a spokesperson for the charity told The Pharmacist.

Endometriosis, where cells similar to those in the lining of the womb grow elsewhere in the body, can cause inflammation, pain and the formation of scar tissue, and affects one in 10 women and those assigned female at birth, Endometriosis UK said.

Of the 4,371 survey participants who had received an endometriosis diagnosis from a healthcare practitioner in the UK, an average diagnosis time of eight years and 10 months was recorded in England and Scotland, while in Northern Ireland diagnosis could take an average of nine years and five months, or nine years and 11 months in Wales.

This was compared to a 2020 average of eight years in England, eight years six months in Scotland and Northern Ireland, and nine years in Wales.

‘The earlier endometriosis is suspected the greater the impact to reducing diagnosis times,’ Joanne Hanley, an endometriosis specialist advisor and NHS advanced clinical practitioner and endometriosis specialist nurse told The Pharmacist.

‘Considering endometriosis as a cause of symptoms is the initial step to seeking a timely diagnosis and improving accessibility to treatment,’ she added.

And she suggested that more training should be given to community pharmacists on the condition, given that patients often present at pharmacies with symptoms as a first port of call.

‘Pharmacists can advise, offer treatment and medications for a range of conditions. With increased training, awareness and recognition of endometriosis symptoms, pharmacists will be more equipped to advocate for their patients,’ Ms Hanley said.

A report published by the charity suggested that ‘societal and cultural dismissal of period pain as "normal" or not serious’ could result in people with symptoms not seeking medical help, ‘especially when they know the NHS is under pressure’.

‘Without a diagnosis, the disease may progress, risking permanent damage to internal organs and worsening physical symptoms and mental health impacts,’ the report said.

But it suggested that there was a ‘demonstrable lack of awareness of endometriosis and its symptoms by healthcare practitioners, along with a lack of understanding – or sometimes belief – in its impact’.

‘This means that those seeking help for their endometriosis symptoms can have their concerns dismissed or diminished, making timely diagnosis far less likely,’ the charity added.

The Endometriosis UK survey found that prior to receiving a diagnosis of endometriosis, 52% of respondents had presented at an accident and emergency (A&E) department after experiencing severe symptoms.

But only 2% were investigated for endometriosis. Meanwhile, 25% were prescribed painkillers; 19% were told to go home; 19% were told to buy over-the-counter pain killers; 18% were investigated for things other than endometriosis; 17% were seen by a gynaecologist or referred to one; 12% were admitted to hospital; and 4% had emergency surgery.

The charity has called for improved education about endometriosis and menstrual health for community pharmacists and other healthcare professionals.

‘Royal Colleges and relevant professional bodies should improve the provision of education on endometriosis and menstrual health as part of specialist and ongoing training, with a particular focus on GPs, Gynaecologists, nurses, A&E practitioners and community pharmacists,’ the report said.

The Centre for Pharmacy Postgraduate Education (CPPE) told The Pharmacist that it hoped to add more endometriosis content to its learning platform next year.

Its women's health and menopause learning gateways were added last year, signposting to CPPE learning programmes, key learning resources from other professional providers - including the Royal College of GP's resources on endometriosis - as well as national policy, strategy and guidance.

'Our focus so far has been on developing learning resources for pharmacy professionals to offer better support for people going through the menopause, we hope to build on this next year with more resources to support women’s health including a focus on endometriosis,' a spokesperson told The Pharmacist.

And Professor Claire Anderson, president of the Royal Pharmaceutical Society (RPS), told The Pharmacist: 'Community pharmacists have a crucial role in providing accessible services for women’s health.

'Our women’s health policy highlights pharmacists significance in encouraging discussions about menstruation, helping with early detection of conditions like endometriosis, and providing essential treatment and referrals.

'Whilst accessible training modules and resources are already in place, we always advocate for ongoing education to ensure the highest standards of patient care.'

The RPS also highlighted other training resources available, including NHS National Education Scotland's webinar on women's health, HRT and contraception, educational content open to pharmacists through the Scottish Government Women's Health plan, and the RPS webinar on Women's Health in the Workplace: Menopause and Mental Health (rpharms.com)