Over two years after the cervical cancer campaigner’s passing, Ireland still has a long way to go when it comes to making the necessary changes for women to feel safe and cared for.

Yes, there are major improvements. Women aged 17 to 35 can get free contraception, six specialist menopause clinics are operational, a publicly funded Assisted Human Reproduction (AHR) treatment can be accessed via regional fertility hubs, and perinatal mental health services are now provided in 19 maternity services.

Last February, Stephen Donnelly, who was at the time minister for health, said he had promised a “revolution in women’s health”. While it is important to pause and acknowledge achievements and new systems being put in place, how can there be a revolution when women still aren’t being heard in their first pleas for help.

Perhaps, we should go back to the basics and focus on listening. Perhaps, that’s where the revolution should start when it comes to women’s health in Ireland.

A global survey from 2024 measuring how 143 nations perform in key areas of women’s health and well-being found that Ireland ranked 63rd on preventive care.

In the course of researching features on this issue, I have sat down with dozens of women who told me about their health, the painful symptoms they experience on a daily basis, how they feel dismissed by their GPs, how no one seems to be taking them seriously.  

They often start with the same sentence - “If it was a man’s issue…” and I think they have a point.  The healthcare system in my native Belgium is certainly not perfect, but one of the things that surprised me most when I moved here is how dismissive health professionals can be - a dismissiveness women seem to experience more.  

Everyone’s experience is different, of course, but at home, I have never felt like I wasn’t taken seriously whenever I brought up my pain.  

March marks endometriosis (endo) awareness month, a chronic condition that impacts one in 10 women, yet one that is still not taken seriously and is poorly researched. There is still no cure for endo, although surgery can bring relief to some.  

Historically, the healthcare system was made by men for men. But it would be only fair to think that in 2025, it would take women’s accounts more seriously. That women would at least be heard.

Ireland's endometriosis treatment

As the Irish healthcare system fails to provide women with proper services and as the waiting time for diagnosis amounts to an appalling eight years on average, they are forced to seek alternative lines of treatment. 

In Romania, women from all over the world get the help of endometriosis specialists at the Bucharest Endometriosis Center, an integrated facility for diagnosis and surgical treatments of endometriosis. Every year, between 100 and 150 Irish women flock there to get the surgeries and healthcare Ireland cannot offer them.

While treatment is available under the EU Cross Border Healthcare Directive, Ireland needs endometriosis specialists. Even though the cost of healthcare abroad is reimbursed under that scheme, not everyone has the means to put this kind of money aside - and some even have to take out loans. 

Some women who travelled to Romania have told me it cost them about €8,000 overall.  The healthcare cost might be reimbursed, but the scheme does not cover travel expenses, accommodation and day-to-day necessities. 

Some women I have spoken to found themselves in a situation where they had to travel alone, with no support system, because it would be too costly for someone else to travel with them.

I was diagnosed with endometriosis in 2021. Two years ago, I found myself in an ambulance on my way to UHL after suffering from intense pelvic pain and unable to move, to sit, or to stand. 

I sat on a chair for about six hours before being seen by anyone, and was asked several times if “I was sure I didn’t have to use the bathroom”, if maybe, that was the root of the problem. I had told them about my endometriosis, but no one seemed to listen.

I was appalled, but not surprised. My research had introduced me to women who waited over 10 years to simply get a diagnosis, who were misdiagnosed then found out their condition was extensive, something that could have been prevented. 

I talked with women who were told to get pregnant so they wouldn’t be in so much pain, and many, many women who were told “it was just bad periods”. Recently, I spoke with someone who was found to have endometriosis lesions near her heart, as her condition got worse – something that could have been prevented if she did not have to wait years to get properly diagnosed.

The National Framework for Endometriosis which aims to see the standard of endometriosis care improved was due in April 2024 – a framework which is still to be published. While regional hubs being developed is a step forward, the lack of endometriosis specialists in the country is worrying.  

The condition is often perceived as gynaecological, but it is an inflammatory disease which can be found on any organ of the body.  That’s why an endometriosis hub should have a multidisciplinary team - and for that, we need more funding. 

For example, in Belgium’s Erasme hospital, there is a clinic dedicated to endometriosis, with gynaecologists, specialist surgeons, urologists, gastroenterologists, fertility experts, as well as sex therapists and physiotherapists.  

Many women go to their GPs to get a referral letter - and feeling heard proves to be quite the challenge in itself. Perhaps, we could start there and wait times could be reduced dramatically if their pain was taken seriously from the get go.  

The healthcare system won’t be fixed in a click of the fingers, but hopefully, we won’t have to wait for the next generation before we see more change.  

During a keynote speech in 2019, Vicky Phelan said: “I have a 13-year-old daughter, and that's who I'm doing all of this for. 

"If I die, I want to make sure that we have a health system that is something that I can trust to leave behind, that if she develops anything over the years, if I'm not here, that there's a healthcare system that I can say with hand on heart, I've helped to make it better for her and for all of the other girls”.

It’s time for those words to be properly heard - and heeded. 

• Manon Gilbart is an Irish Examiner journalist.