UK gynaecological care crisis: why thousands of women are left in pain

If all the women waiting for NHS gynaecological appointments in the UK were to stand in line, they would stretch from London to Exeter.

That's according to a report by the Royal College of Obstetricians and Gynaecologists (RCOG), which found that about 750,000 women across the four nations are waiting for NHS appointments – a number that has more than doubled since February 2020, according to the BBC. And the real number "could be considerably more"; these are just the women who have already been referred onwards by a GP.

Women are waiting for treatment for conditions from "fibroids and endometriosis to incontinence and menopause care", but also for urgent appointments for suspected cancer. "Women are being let down," said Dr Ranee Thakar, president of the RCOG. Change is "urgently needed".

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Why is the waiting list so long?

"Gynaecology is the only elective specialty that solely treats women," said Thakar. The disproportionately long waiting list reflects the "persistent lack of priority given to women and women's health".

The reasons for that are "complex and multi-faceted", she told the i news site. But the problem predates the Covid-19 pandemic. The growth of gynaecological waiting lists has been "outstripping other specialties since April 2018".

Women's health has long been "under-treated and under-researched", said the news site. Although one in three UK women suffer from a gynaecological health problem, less than 2.5% of publicly funded research is dedicated to reproductive health.

"There is apparently five times more research into erectile dysfunction, affecting 19% of men, than into premenstrual syndrome, which affects 90% of women."

This contributes to long diagnosis times and "poor treatment options", said Thakar, leaving women "struggling" with symptoms that impact their health and quality of life. Every month more patients are referred to gynaecology services than are seen, driving "a steady increase in waiting lists".

In fact, waiting times have tripled over the past decade, according to analysis by the Nuffield Trust and the Health Foundation. Between 2014 and 2024, the waiting list for gynaecological care rose by 223%: "faster than the overall NHS waiting list", said The Telegraph.

What is the impact?

One woman told The Times she suffered from "excruciating" non-stop pain and near-constant bleeding. She was diagnosed with endometriosis in 2020, and is still waiting for surgery.

More than three-quarters of women waiting for care reported worsening mental health, Thakar wrote in The Guardian. More than two-thirds said they were "unable to take part in daily activities", including work, socialising and caring responsibilities, due to severe pain or symptoms. Many experience exhaustion, dizziness, anaemia and infections because of "worsening conditions".

This "dire situation has repercussions for the whole NHS". A quarter of the women surveyed for the report had been to A&E, many needing "emergency interventions" – when they could have been treated as outpatients had they been seen earlier. This is "costing the country millions".

Women's absences from work due to health conditions like severe period pain and ovarian cysts cost the economy nearly £11 billion per year, according to a recent report by the NHS Confederation. Unemployment due to menopause symptoms also costs about £1.5 billion a year.

For every additional pound invested in gynaecology services per woman in England, there would be a return of about £11 for the economy, the report found. "That's an additional £319 million of gross value added across the whole economy," wrote Thakar, "just from prioritising women's health."

What can be done?

The NHS Confederation report recommended "allocating ringfenced funding" to women's health, to help close the "gender health gap at pace".

It also recommended additional funding throughout the country, improved education and training for doctors on women's health conditions, and an ambassador for women's health focused on improving outcomes for Black, Asian and minority women, which are significantly worse.

The RCOG is also calling on Labour to deliver "an urgent package of support for women" on the waiting list, said The Times.

"Too many women are facing unacceptable waits for gynaecology treatment," a Department of Health and Social Care spokesperson told the paper.

Labour is "overhauling women's healthcare". A 10-year plan backed by a £22.6 billion increase in day-to-day health spending will bring down waiting times, so women get "the support they need when they need it".