Where does this news come from?
KCE report How to improve endometriosis care in Belgium? (1) presents a number of recommendations that were explained in Standard Dated April 4, 2024. The report states that endometriosis is a A very complex case It is, with too Variable impact on quality of life and fertility. the Diagnosis is not easy. This is one reason why many women with endometriosis feel misunderstood.
The Health and Science Organization and the Flemish General Practitioners Association Domus Medica welcome the recommendations formulated by the KCE to address the care of endometriosis (and complaints of chronic pelvic pain) in a structured way in order to help women with endometrial cancer. Diagnosis is faster and more efficient. Endometriosis action plans are also being developed in other European countries.
However we think it is important Very important To continue to consider the consequences of this increased vigilance and the care provided that accompanies it. Every treatment given, including the treatment to be given, must be through a well-organised system Quality of life For the largest possible number of women with endometriosis Improve effectively. For this reason, as the KCE report also states, A It is necessary to carefully follow up on the measures taken.
The report focuses strongly on: Diagnosis and treatment. However, many endometriosis guidelines emphasize that there are: Much is still unknown It revolves around the uterine lining Scientific proof for some treatments is very limited He is.
source
(1) KCE. How to improve endometriosis care in Belgium?
How should you interpret this news?
Health, Science and Domus Medica also request that attention be paid to Potential harmful effects Of the planned measures, they have consequences Overdiagnosis and overtreatment.
Too much is not always good
Italian experts argue in a recent reflective article to limit the number of interventions in the context of endometriosis: they say that more is not always better (2). One of their 10 pieces of advice warns against surgical intervention too quickly if abdominal pain is more or less controlled with medication. a You should avoid surgery unless it is absolutely impossible. Endometrial lesions can also return after surgery and subsequent operations are generally more difficult.
That's why it must be done Potential benefit and potential harm Every proposed medical procedure is thoroughly discussed.
When do you go to the doctor?
It is also necessary for women to learn at an early age (at school, for example). Report painful periods And when you should or should not consult a doctor. A survey of 42,000 Dutch women showed that 85% of them experienced painful periods every month (3). Most of them do not have endometriosis.
Our health care system can become overwhelmed because many women with painful periods now fear endometriosis and go to the doctor. This can lead to unnecessary tests and treatments.
Conclusion
It is important that more attention is paid to endometriosis, but we must at all costs avoid this leading to an irresponsible increase in medical and surgical procedures. Now there is an impression that doctors do not listen to these complaints. This is a very one-sided view of the issue. Even if we improve interest in the medical profession, medical intervention will not always lead to a solution to this complex condition. We miss this little nuance in the report.
References
- (2) Endometriosis ETIC treatment at the Italian Club. When more isn't better: 10 “don'ts” in endometriosis management. ETIC position statement*. Hum reprod open. 2019;2019(3):hoz009.
- (3) Schoep E, Niebuhr T, van der Zanden M et al. Impact of menstrual symptoms on daily life: a survey of 42,879 women. Am J Obstet Gynecol 2017;220(6):569.e1–569.e7.
