Seanad hears women patients being misled over endometriosis

Poorly trained GPs are effectively “gaslighting” female patients that the pain they suffer with the chronic condition endometriosis is not really happening and “all in their heads”, the Seanad has heard.

Fianna Fáil Senator Lisa Chambers said one in 10 women and girls suffer with the incurable gynaecological condition, which includes chronic pain and fatigue, heavy bleeding, infertility issues and leads to mental health problems.

“There are no clear clinical guidelines for GPs, no clear care pathway through the health service and it takes an average of seven years for women to get a diagnosis while many report it can take 10 years,” she said, adding that “the longer it’s left to wreak havoc internally the more damage it does”.

The issue was one of a range brought up by Senators on international women’s day affecting women including reproductive health, ownership of the national maternity hospital, equal pay, numbers of women in senior academic positions, VAT on sanitary and incontinence products and domestic violence.

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Ms Chambers said GPs are not properly educated and trained to identify the condition. Women are being prescribed anti-depressant medication and told “it’s all in your head, it’s all part of being a woman, you just need to buck up and deal with the pain because that’s just your lot”.

Many women report “being effectively gaslit by their GP and being told that what they’re feeling themselves is not really happening and it’s all in their heads”.

Ms Chambers appealed for “urgent action, clear clinical guidelines, a care pathway for treatment and education among GPs to spot the symptoms early on”.

Her party colleague Senator Erin McGreehan said more than 30,000 women are on a waiting list for gynaecological appointments.

Minister of State for Health Anne Rabbitte acknowledged that "no man in the country would put up with this".

She stressed the Government’s commitment to improving women’s health outcome and €12 million was provided in the budget for new developments in maternity and gynaecology services.

Phase one of a “see-and-treat” model of one-stop ambulatory or walk-in gynaecology clinics to replace the traditional outpatients’ referral system has begun in Cork and Galway hospitals with services to start this year in the Rotunda and Waterford hospitals.

Ms Rabbitte said this was not nearly enough and “we have to give women back their lives” with “ a proper ambulatory service throughout the country”.

Senators were also told Ireland is the only EU state with zero-VAT period products such as tampons and sanitary towels.

Minister of State for Finance Seán Fleming said this is in place since 1991, before the European Union VAT directive, but new reusable products on the market since then including period underwear, menstrual cups and sponges are charged at 13.5 per cent VAT.

Zero rate

Ireland and several other EU states are looking for the directive to allow a zero rate for these new period products.

Sinn Féin Senator Lynn Boylan, who raised the issue of VAT being charged on sustainable products, said the 13.5 per cent is a higher VAT rate "than going to a restaurant or pub and a rate almost three times that of trading a greyhound".

She also expressed concern that incontinence pads are taxed at the highest 23 per cent rate, which applies to luxury goods.

It was another “regressive tax that disproportionately affects women. Incontinence is not a luxury”, she said.

Mr Fleming accepted that luxury rate VAT on incontinence pads can be a very heavy cost for many families. He added that the VAT reduction from 13.5 per cent to 9 per cent in the hospitality sector was a temporary response to support those facing serious economic difficulties due to Covid-19.

He said VAT relates to the type of product rather than whether or not it is sustainable, but it is a “broad issue we will all have to raise at European level”.