Endometriosis and Pelvic Inflammatory Disease (PID) are two conditions which affect a large number of women every year, and can have devastating effects on fertility and well-being, but frustratingly continue to experience long delays in diagnosis.
Endometriosis - a condition where tissue similar to the lining of the womb grows elsewhere in the body - affects around 1.5 million women in the UK. Despite being so prevalent, it typically takes nine years from the onset of symptoms to get a diagnosis. This delay can lead to crippling pain and reduced fertility.
PID is an infection of the female reproductive system which can leave a woman infertile, and with chronic pain unless diagnosed swiftly.
When a delay in diagnosis of PID or endometriosis resulted from medical mismanagement or error, there may be a medical negligence claim for compensation. Kingsley Napley is a specialist in these claims, including where fertility has been impacted.
Endometriosis
Endometriosis can have symptoms similar to other common conditions (including PCOS, ovarian cysts and fibroids) and this can lead to delays or misdiagnosis. According to NICE (National Institute for Health and Care Excellence) guidance, doctors should consider endometriosis when women or girls present with one or more of the following symptoms:
- Chronic pelvic pain
- Period-related pain affecting daily activities and quality of life
- Deep pain during or after sexual intercourse
- Period-related or cyclical gastrointestinal symptoms, in particular, painful bowel movements
- Period-related or cyclical urinary symptoms, in particular, blood in the urine or pain passing urine
- Infertility in association with one or more of the above.
In the first instance, an abdominal and pelvic examination should be offered to those with suspected endometriosis along with a transvaginal ultrasound or possibly a transabdominal ultrasound. Even where the examination and/or ultrasound is normal the possibility of endometriosis should not be excluded. Referral and further investigation may still be necessary.
A delay in diagnosis of endometriosis can lead to prolonged pain and physical symptoms such as infertility as well as psychological symptoms in some patients. There may be a legal claim if it can be shown that the medical management provided was below a reasonable standard, such as a failure by a GP to follow NICE guidance, and that this caused an injury.
New endometriosis treatment
While diagnosis remains a difficult hurdle, NICE has recently recommended the first long-term daily pill to treat endometriosis stating that this could transform how the condition is managed. It is claimed that the treatment (relugolix–estradiol–norethisterone) is faster working than injectable alternatives and can be taken easily at home. This option will be available for patients for whom medical or surgical treatment has failed. It remains to be seen whether this will dramatically improve the landscape for endometriosis sufferers, but early diagnosis remains key.
Pelvic Inflammatory Disease
Symptoms of PID can involve pelvic pain, discomfort during intercourse, pain on urinating, heavy and / or painful periods and unusual vaginal discharge. Most cases are caused by a sexually transmitted infection (such as chlamydia or gonorrhea), but can also be caused by a bacterial infection.
PID can be difficult to diagnose, but when a patient presents to hospital or their GP complaining of some of the symptoms outlined above, an examination and an STI swab should be completed. However, negative swabs do not rule out PID and further investigations such as blood tests may be required.
Once diagnosed, PID can be treated with antibiotics, but delayed diagnosis can cause serious problems including scarring of the fallopian tubes affecting fertility, cause chronic pain and may require surgery.
Fertility claims
It is extremely distressing when a delay in diagnosis of endometriosis or PID has led to reduced fertility. If there has been negligence, a legal claim may include funds for private fertility treatments such as IVF and for psychiatric support. We recognise how difficult the issues involved can be to manage and we support our clients to understand all of their medical options in order to obtain the best possible package of compensation.
If you would like to contact one of our members in the Medical Negligence and Personal Injury team, please click here.
Further information
If you have any questions regarding this blog, please contact Andrea Wadden in our Medical Negligence and Personal Injury team.
About the author
Andrea is an Associate in the Medical Negligence Department. She qualified as a solicitor in 2023 and then joined Kingsley Napley. She has experience in both medical negligence and personal injury claims having worked at a national law firm in Birmingham for five years. She has undertaken work with clients who have sustained a variety of injuries including brain injuries, birth injuries and orthopaedic injuries.
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