A new NHS care pathway designed to speed up diagnosis and treatment for people with endometriosis has been launched in the North West, following two years of focused regional work to improve care for the condition.

Dr Paula Cowan, NHS England North West’s Medical Director for Primary Care and National Specialty Advisor with the Women’s Team, says the new approach marks an important step forward, but warns that significant challenges remain.

Launched in January 2026 in Cheshire and Merseyside, the pathway brings together primary care, secondary care, and public health to reduce waiting times and improve early recognition of endometriosis, which affects around one in ten women aged 15 to 45.

Dr Cowan 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.”

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

For many women, the changes cannot come soon enough.

Two women from Cumbria, Charlotte Martindale and Millie Campbell, both experienced severe symptoms from their teenage years but say their concerns were dismissed.

‘I was made to feel it was all in my head’Charlotte, now 30, described years of debilitating pain in her legs and lower back, heavy bleeding, nausea, bowel issues, and fatigue. Despite this, she says her symptoms were attributed to anxiety and depression.

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

Her experience reflects national data from the NHS Confederation showing that 84% of women report being dismissed by medical professionals.

Charlotte was incorrectly diagnosed with polycystic ovary syndrome 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 its likely further surgery will be needed as the endometriosis regrows.

‘I’ve had to advocate for myself’

Millie Campbell, 20, is still awaiting a formal diagnosis. Her symptoms began when she was 12, causing an almost constant pain, and such severe bloating that her mother feared she might be pregnant when she was just a teenager.

Over the years Millie has been told the heavy, erratic bleeding and pain was due to hormones, stress, diet, and even irritable bowel syndrome.

Despite years of severe symptoms, Millie says 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.

While she waits, Millie works with the charity Woman Up, delivering period education workshops in schools to help young people understand what is – and isn’t – normal.

The workshops cover menstrual health, myth‑busting, and hands‑on demonstrations of period products, aiming to ensure no young person feels as confused or alone as she once did.

A long‑term commitment to improving women’s health

Although 28% of severe endometriosis cases occur in women aged 35–44, the condition can begin much earlier. Dr Cowan says the new pathway is part of a wider commitment to improving women’s health across the region.

“The more people know, the better the understanding,” she said.