A study is examining where delays occur in diagnosing endometriosis  – a condition that can take seven to twelve years to diagnose.

Endometriosis affects an estimated 1.5 million women and people in the UK, but there is currently no consistent way of measuring where and why diagnostic delays happen.

The research aims to develop the first standardised framework for understanding the diagnostic journey and identifying points where interventions could improve care.

The international project involves researchers from the University of Sheffield, University of Liverpool, University of Oxford, Aarhus University in Denmark and the University of Edinburgh, alongside Endometriosis UK.

Dr Rebecca Mawson, NIHR clinical lecturer in primary care at the University of Sheffield, is part of the research team.

She said: “Our project asks: where exactly are people getting lost or let down on their journey to diagnosis, and how can we map those points in a systematic way to identify where interventions could make a real difference.”

The project is led by Dr Babu Karavadra, NIHR academic clinical fellow in general practice at the University of Liverpool, who has been awarded a World Endometriosis Society Early Career Investigator Award as lead principal investigator at the University of Liverpool.

Researchers will review existing evidence, gather experiences from people living with endometriosis and bring together an international panel to map the diagnostic pathway and agree common definitions for key points along the journey.

The work will focus particularly on people whose experiences are often missing from research, including Black women, people living in rural or deprived areas, LGBTQ+ communities and disabled people.

Primary care will also be central to the research because it is often where people first seek help with symptoms.

Mawson said: “Primary care needs to be at the heart of this work. Primary care is often where people first seek help with their symptoms, so it has a crucial role in understanding diagnostic delay.

“If we only look at what happens once someone reaches specialist gynaecology, we risk missing some of the barriers that shape the journey long before that point.”

Unlike cancer research, where internationally recognised standards exist for studying diagnostic delays, endometriosis research has been more fragmented, with studies measuring different parts of the diagnostic journey in different ways.

The researchers hope to create an ‘Endometriosis Diagnostic Pathway Framework’ to help identify where people are falling through the gaps and where healthcare could be improved.

They will also develop a ‘Snakes and Ladders’ style visual representation showing how systemic barriers, chance and individual experiences can influence whether someone reaches a diagnosis.

The project forms part of the PEARL network, Primary care Endometriosis and Adenomyosis Research and Learning, an international collaboration of primary care and community researchers and clinicians.

Mawson said: “Endometriosis diagnostic delay isn’t inevitable. If we can understand where and why people are experiencing barriers, we have a much better chance of designing interventions that actually make a difference.

“The scale of the problem demands that we look at the whole journey, listen to the people experiencing it and build an evidence base that can lead to real change.”

The framework could provide the foundations for future research, clinical guideline development, healthcare professional training and NHS service improvements, with potential applications to related conditions such as adenomyosis and chronic pelvic pain.

Calla Lily Clinical Care has joined a US$50m antibiotics programme to assess vaginal delivery of UTI treatments through its Callavid platform.

The women’s health medical technology company will evaluate whether antibiotics can be delivered directly through the vaginal wall to treat urinary tract infections (UTIs).

The project will use Callavid, the company’s intravaginal drug delivery platform, aiming to deliver treatment to the site of infection while limiting systemic exposure.

Calla Lily has been selected for Wellcome Leap’s Focused Antibiotics programme, which is exploring ways to reformulate existing antibiotics so they reach infections while sparing the gut microbiome without loss of efficacy.

Dr Serena de Gelidi, Principal Investigator and R&D Manager, Calla Lily Clinical Care

The programme is backed by US$50m and aims to investigate technologies that could reduce the unintended effects of antibiotic treatment.

UTIs are among the most common bacterial infections in women. According to the source material, women are prescribed almost 40 per cent more antibiotics than men between the ages of 16 and 54.

Calla Lily will assess whether Callavid can deliver antibiotics through the vaginal wall while bypassing gastrointestinal transit and first-pass metabolism.

The company expects the approach could keep systemic exposure below 5 per cent.

There is currently no first-line UTI antibiotic available in a mass-manufactured vaginal formulation, according to Calla Lily.

The company said a successful project could contribute to the wider programme’s goal of reducing antibiotic-driven resistant infections by up to 40 per cent a year.

Callavid has a patented, leak-free, tampon-like design intended to deliver medicines and hormones through the vagina.

The platform is already being assessed in the NIHR-funded FREEDOM trial, which is studying vaginal progesterone delivery using Callavid.

That study began in April 2026 and is examining safety, user acceptability and drug absorption. According to the company, it has passed its safety stopping rule and 90 per cent of patients have completed their first round of dosing.

Dr Lara Zibners, co-founder and chair of Calla Lily Clinical Care, said: “Women are disproportionately impacted by urinary tract infections, yet the consequences of that repeated systemic exposure have been largely overlooked. Organisations such as Wellcome Leap play a vital role in tackling major healthcare challenges through bold innovation. We are honoured to be part of the Focused Antibiotics programme and to explore the potential of Callavid in a foundational antibiotic application, demonstrating how women’s health innovations can deliver benefits far beyond fertility and reproductive care.

Thang Vo-Ta, co-founder and chief executive of Calla Lily Clinical Care, said: “Being selected by Wellcome Leap, one of the world’s most ambitious health innovation funders, is a significant validation of what we are building at Calla Lily Clinical Care. Our ambition has always been for Callavid to become the defining platform for intravaginal drug delivery across a wide range of indications. The Focused Antibiotics programme gives us the ideal partner to pursue one of the most consequential of those indications: treating the world’s most common bacterial infection in women while helping to address a global resistance crisis that, left unchecked, could claim eight million lives annually by 2050. This marks a pivotal moment in demonstrating that when you solve for women, you solve for everyone.”

The project will be led by Dr Serena de Gelidi, principal investigator and R&D manager at Calla Lily Clinical Care.

She will be supported by Professor Andrew Lewis, principal scientist at the company and an international authority on drug-eluting systems, with 58 patents and more than 260 peer-reviewed publications.