A new NHS North West pathway aims to improve treatment and cut waits for people with endometriosis.

The pathway, launched in Cheshire and Merseyside, brings together primary care, secondary care and public health to reduce waiting times and recognise the condition earlier.

Endometriosis affects one in 10 women aged 15 to 45 and currently takes an average of eight years to diagnose.

The programme includes new learning resources for healthcare professionals and a renewed focus on raising public awareness of the condition.

Charlotte Martindale, 30, has had debilitating pain, heavy bleeding, nausea, bowel issues and fatigue for years, but her symptoms were attributed to anxiety and depression.

She said: “When I got to university the pain became unmanageable. I really felt as if I wasn’t being listened to and was made to feel like it was all in my head.”

Charlotte was incorrectly diagnosed with polycystic ovary syndrome (PCOS) before eventually being referred to gynaecology.

She says she was told a laparoscopy, the only definitive diagnostic procedure, would not be offered because she was not trying to conceive.

After 14 years of symptoms, an internal ultrasound finally revealed multiple endometriomas.

She was referred to the endometriosis centre in Preston and underwent surgery in 2025, where deep infiltrating endometriosis was found on her bladder, bowel and appendix, and had stuck her ovaries to her pelvic wall.

Although the surgery was successful, Charlotte has been told it is likely further surgery will be needed as the endometriosis regrows.

Data from the NHS Confederation showed that 84 per cent of women reported being dismissed by medical professionals.

Millie Campbell, 20, is still waiting for a formal diagnosis.

She has had heavy, erratic bleeding, pain and severe bloating since she was 12, but she was told she was “too young” to have endometriosis.

“I’ve been on several different contraceptive pills, but none of them have worked,” she said.

“The pain feels like a ball of barbed wire, and regular pain relief just doesn’t touch it.”

After an MRI last year, she is still waiting to find out whether she will be offered a laparoscopy.

Dr Paula Cowan, NHS England North West’s medical director for primary care and national specialty adviser with the women’s team, says the new approach marks an important step forward, but warns that significant challenges remain.

She said: “Early consideration and recognition of endometriosis is key, both in general practice and in the community. The earlier endometriosis is recognised and diagnosed, the better the care the NHS can give.”

“In this new pathway, we’ve looked closely at how engaging with patients and GPs, workforce planning and better use of data can help reduce waiting lists and ensure people get the help they need.”

“Too many women feel that they have not been listened to regarding their heavy, painful periods are normal.”

“From the very first contact with a patient presenting with heavy painful periods, we need to be thinking could this be endometriosis.”

Dr Cowan says the new pathway is part of a wider commitment to improving women’s health across the region.

NICE has updated fertility guidance with a new endometriosis section for people struggling to conceive.

This follows feedback received during public consultation, recognising for the first time that the condition requires its own tailored approach to fertility care, separate from other causes of infertility.

Emma Cox, chief executive of Endometriosis UK, said: “This year’s Endometriosis Action Month theme is ‘Endometriosis Doesn’t Wait’ and our new State of Endometriosis Care report shows just how urgently change is needed.

“With average diagnosis times now standing at 9 years and 4 months, and 11 years for those from ethnically diverse communities, many have already waited far too long by the time they reach fertility services.

Today’s guidance marks a step change in the fertility support that anyone with endometriosis should receive.

“For years, those with endometriosis have told us they felt invisible within the fertility system, grouped with unexplained infertility despite having a diagnosed condition.

“We welcome NICE’s decision to listen to patient voices during consultation, to create a dedicated pathway, and to remove misleading labels like ‘mild’ and ‘severe’ endometriosis.”

“Endometriosis doesn’t wait. And now, at last, neither will the guidance.”

Endometriosis UK and others told NICE during consultation that endometriosis was being grouped with unexplained infertility, despite it being a diagnosed condition.

The committee agreed this was inappropriate and that endometriosis requires a distinct fertility pathway.

Respondents also told NICE that terms such as “mild” and “severe” endometriosis were clinically ambiguous and did not reflect the complexity of the condition or its impact on fertility.

The committee agreed and those terms have been removed from the final guideline.

Under the new recommendations, clinicians will discuss a range of options with patients with endometriosis who are trying to conceive, taking into account individual factors including how long they have been trying to conceive, the severity of their symptoms, their age, their ovarian reserve, which is a measure of remaining egg supply, and any male fertility factors.

The guideline sets out a treatment pathway. Where appropriate, expectant management, meaning time to try to conceive naturally, may be offered, or surgical treatment to address endometriosis, in line with NICE’s existing endometriosis guideline (NG73).

If neither approach is suitable or successful after 2 years, fertility treatment options including intrauterine insemination (IUI), where sperm is placed directly into the womb, or IVF will be discussed.

The new guidance supports the ambitions set out in the NHS 10 Year Health Plan, which commits to shifting care closer to home and empowering patients and professionals to make the best choices about treatment.

Setting out a clear, personalised pathway in the guideline for endometriosis helps ensure fertility services are better tailored to individual need, reducing variation in care and supporting equitable access across England.

Eric Power, interim director of the Centre for Guidelines at NICE, said: “We listened carefully to what patients, clinicians and patient groups told us during consultation.

“They described how complex endometriosis is, how they felt existing labels were misleading, and that the condition needed its own pathway. The committee agreed and acted on that feedback.”

“By creating a dedicated section for endometriosis, we are giving clinicians a clear, evidence-based framework to have better, more personalised conversations with their patients, ensuring that everyone, regardless of the cause of their fertility problems, has access to the right care at the right time.”

Public health minister Sharon Hodgson said: “Every woman with endometriosis deserves fertility care that recognises the complexity of her condition.

“This landmark guidance will ensure women can access a clear, personalised pathway to fertility care that leads to clearer conversations with clinicians and fewer barriers.

“We’re committed to giving every woman the support she deserves, and today’s guidance is a significant step towards ending the inconsistency that has let down too many, for too long.”

To mark Endometriosis Awareness Month, Women’s HealthX is excited to announce that Padma Lakshmi will join the event as a keynote speaker, bringing one of the most influential voices in women’s health advocacy to the stage.

Boston, March 30 2026 – New York Times bestselling author and Emmy nominated host and executive producer of Hulu’s Taste the Nation, Padma Lakshmi, is widely recognized for her impact across media, culture, and advocacy.

Named one of Time Magazine’s 100 Most Influential People in 2023, she has become a leading voice in women’s health through her advocacy on endometriosis.

Having spoken openly about her own experience with the condition, Lakshmi has helped raise awareness of delayed diagnosis, chronic pain, and systemic gaps in care.

As co-founder of the Endometriosis Foundation of America, she has played a key role in advancing education, research, and policy attention for a disease that affects millions globally.

At Women’s HealthX, Lakshmi will headline a fireside chat titled The Invisible Disease: What Endometriosis Reveals About the Future of Women’s Health. Endometriosis remains widely misunderstood, underfunded, and frequently diagnosed years too late.

Using the condition as a case study, the session will explore broader systemic challenges across women’s health, from research inequities to clinical blind spots.

The discussion will focus on how to create a clearer roadmap for policymakers, payers, and innovators committed to accelerating earlier diagnosis, improving treatment options, and driving more equitable investment in women’s health.

Attendees will gain insight into how addressing endometriosis can unlock wider progress across the healthcare system.

Through her advocacy and public voice, Lakshmi continues to challenge stigma, amplify underrepresented experiences, and call for a healthcare system where women’s pain is recognised and addressed.

At Women’s HealthX, audiences will hear firsthand what endometriosis reveals about the future of women’s health from one of its most influential and fearless advocates.

Find out more about her session at Women’s HealthX.

As the leading global event in women’s health, the exhibition unites stakeholders across the full lifecycle of care, bringing together over 750 leaders from pharma, biotech, healthcare systems, insurers, and government, all focused on implementing solutions that close the sex difference data gap and improve outcomes for women worldwide.

Attendance is free for any medical officers and leaders within hospitals and healthcare systems, pharma, biotech, corporate enterprises and government officials.

Register your free place now

More about Lakshmi:

Alongside being the cofounder of Endometriosis Foundation of America, Lakshmi is also the creator and host and executive producer of America’s Culinary Cup, a new culinary competition show premiering on CBS in spring 2026 following the 50th season premiere of Survivor.

She is the creator of the critically acclaimed and Emmy nominated Hulu series Taste the Nation, which won the James Beard Foundation Award top prize in Visual Media Long Form, and previously served as host and executive producer of Bravo’s two time Emmy winning series Top Chef for 19 seasons, earning five Emmy nominations for Outstanding Host for a Reality Competition Program.

Beyond television, she serves as an American Civil Liberties Union Artist Ambassador for immigrants’ rights and women’s rights and as a Goodwill Ambassador for the United Nations Development Program.

She is also a visiting scholar at the Massachusetts Institute of Technology.

Lakshmi is the author of several books, including Easy Exotic, Tangy, Tart, Hot & Sweet, and her New York Times bestselling memoir Love, Loss and What We Ate. Her other works include The Encyclopedia of Spices & Herbs, the children’s book Tomatoes for Neela, and Padma’s All American: Tales, Travels and Recipes from Taste the Nation and Beyond, launching in November 2025.