Endometriosis Education in Schools

I beg to move,

That this House has considered endometriosis education in schools.

It is a pleasure to serve under your chairmanship, Ms Vaz. I have been trying to raise awareness of endometriosis for several years now. I am proud of the work done by not just me but other colleagues across the House, not least our late, great friend Sir David Amess, on raising the issue of endometriosis—something that, surprisingly, so many people, men and women, still do not know about. In various debates, especially those about endometriosis in the workplace, we have started to raise the profile of the disease, and more and more people are speaking about it. But it is surprising how few people recognise the condition. An e-petition that closed in March 2023, “Include PCOS & Endometriosis education in the national secondary curriculum”, gained only 3,105 signatures. Yet the people who deal with endometriosis know that thousands—in fact, millions—of women are affected by the disease.

Today, I seek to address the issue by asking my right hon. Friend the Minister to prescribe the teaching of endometriosis in the national curriculum, hopefully for this September. I will start by re-highlighting the disease and its impact, because that is important. I will highlight some issues from a 2019 report by Keisha Meek of Northern Endometriosis Sisters Support, because she summarises things well:

“Endometriosis comes with many symptoms, these symptoms do not just occur at the time of a woman’s period.”

The most common symptoms are abdominal cramps, back pain, severe menstrual cramps, abnormal and heavy bleeding, painful bowel movements, pain urinating, painful sex, difficulty becoming pregnant, nausea and sickness. The impact that can have on women’s lives and relationships is enormous. The report says of relationships:

“Long term conditions can have a significant impacts on relationships between family, friends and partners. This can be due to various different reasons such as not understanding, lack of information, taboo around the illness, not publically understood or spoken about. Women who suffer with endometriosis are regular called liars, told it is ‘just a bad period’ and called dramatic. It is known in other long term illnesses that people also…struggle to understand.”

That first paragraph emphasises why I have brought this debate today. The report goes on:

“We have found many women within the endometriosis community have lost friends, this is due to them having to cancel plans due to severe pain and bleeding. Sometimes they have been bed bound, even when they have explained to their friends why they can be left out, not invited or treated like liars. It can be a very isolating experience for women or anyone living with a chronic illness.

As well as friendships we have found women have had issues with their families, resulting in family members no longer speaking to them or inviting them to events. Even after trying to educate their families, the taboo around endometriosis makes this difficult and lack of understanding/knowledge. This is also an issue within other long term condition communities.

We have many women with endometriosis who stay single to protect themselves due to issues in previous relationships. There are women whose partners have left them due to endometriosis, this can be due to sex, the woman’s psychical health and mental health, infertility and many other issues that endometriosis can cause. Women have unfortunately been victims of domestic abuse, their partners excuse being endometriosis or rape due to them saying they can’t have sex due to pain.”

Then, there are the issues at work:

“Many women work with endometriosis, however this can be a struggle and there is lack of understanding for endometriosis sufferers as this is not well known. They are also not protected under the disability act.”

The hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) and I recently met some campaigners, along with the Disability Minister, my hon. Friend the Member for Mid Sussex (Mims Davies), and we are trying to move that forward in a separate piece of work. This issue must be addressed through the work of a wide range of Departments.

Endometriosis results in people having to take a long time off work. In most cases, women find themselves on sickness plans that they are unable to adhere to, which can result in the termination of their employment. A lot of women find themselves moving around jobs trying to survive and pay bills. Due to sickness, many women have felt discriminated against. That is at the heart of why I want the disease to be part of the curriculum. This debate is not just about women who suffer from endometriosis; it is about society as a whole understanding this disease.

I give credit to Essex Police: shortly after my debate on endometriosis in the workplace, it contacted me to ask whether there was more that it could be doing. There are employers out there who are proactively moving ahead, but one reason why this should be on the curriculum is that it is important that everybody is taught about this disease.

I pay tribute to the work that the right hon. Gentleman has been doing on this issue. I am slightly concerned about the latest sex and relationship guidance that the Government have published, because it removes a previous reference to menstruation on the curriculum in primary schools, with this “Not before year 4”.

Obviously, the average age for girls to start their periods is 12. However, data shows that some girls start aged eight and younger, so removing that reference means that some girls could be starting their periods before actually receiving any education on what periods are. The same guidance also removes the reference to males having the education at primary school. Surely the Government think that it is important for girls and boys to understand all about periods. Again, I pay tribute to the right hon. Gentleman’s work in securing this debate.

I am most grateful to the hon. Lady—my hon. Friend; we have done a great amount of work on this together. This is truly a cross-party effort, also involving the hon. Member for Strangford (Jim Shannon); I know the hon. Member for Livingston (Hannah Bardell) would want a mention of the work she has done.

The hon. Member for Kingston upon Hull West and Hessle is right, and I am going to touch on some of that later on; I have also had representations from people to touch on that issue. The hon. Lady mentioned the reason why I am glad we are having this debate: it is highly relevant, based on the statement made last Thursday. I am glad that the Minister has been able to find time to respond to this debate, because it is absolutely right that we try to use this moment to highlight the point.

People with endometriosis also have a higher risk of the following diseases. That is important because we educate about those diseases, but we are not educating about endometriosis. Compared with the general public, sufferers have: a 37% higher chance of developing ovarian cancer; a 38% higher chance of developing endocrine tumours; a 26% higher chance of developing kidney cancer; a 33% higher chance of developing thyroid cancer; a 37% higher chance of developing brain tumours; a 23% higher chance of developing malignant melanoma; and a 62% higher chance of having a heart attack, and that is a direct result of blood loss and anaemia.

Another account I have is from a lady who contacted me after I went to the premiere of “Below the Belt” in 2022, which I recommend to anybody who has an interest in this subject. I am going to read her description because it paints the picture of why this is so important.

“I am a stage 4 endometriosis sufferer, in which it took over 15 years to be diagnosed, in which time my story, in brief, was:

The right hon. Gentleman is absolutely right. As he has pointed out, the figure is 10%. That means that in every classroom, three or four girls potentially have endometriosis, and yet the subject is still not covered. I strongly suggest that we look at covering it specifically, as mentioned, and as early as possible, because this has an impact on girls taking exams. It is exam season right now, when they are in the middle of their GCSEs. Some girls will be sitting their GCSEs now, suffering from endometriosis. It should stop being a taboo subject; it happens to lots of us. Let us make it more publicly known.

On the hon. Lady’s point, I am rather concerned about reports in the press about schools not allowing girls to use the toilets, saying that they have period passes and that they should plan around it. All those policies are set up around normal periods. That goes to show that there is a distinct lack of understanding throughout, not just in the curriculum but throughout the school’s policies. That is why it is vital to move this issue forward quickly.

I did some research, which I am sure the Minister is well aware of, about what happens at each key stage, and how physical health education is taught. At key stages 4 to 5, lessons on fertility and pregnancy choices include how an individual’s fertility changes over a lifetime, and where to seek medical help and emotional support. Key stages 3 to 5 include “The Truth, Undressed” lessons, in collaboration with Canesten—a set of four lessons promoting understanding of vulval and vaginal health. Key stages 3 to 4 include lessons on breast cancer, in collaboration with breast cancer charity CoppaFeel!, to encourage young people to get to know their bodies and adopt healthy behaviours from a young age. This lesson includes essential knowledge about breast cancer, information on healthy lifestyle choices that may reduce a person’s risk of getting cancer, guidance to help them get to know their bodies, and guidance on what to do if they find something that is not normal for them. Key stages 3 to 5 include lessons on testicular health, with information on testicular torsion, orchidectomy and testicular cancer.

I am sure everyone here agrees that that is highly important education, and that cancer is a terrible disease. That is the word: it is a disease. Endometriosis is a disease, and it should be getting exactly the same treatment in the curriculum as other diseases. I noted the Secretary of State’s comments about a range of diseases that are being looked at with a view to bringing them into the curriculum, but I am specifically talking about endometriosis today to push the issue forward.

I thank the right hon. Member for Elmet and Rothwell (Sir Alec Shelbrooke) for highlighting the issue in this debate. He has done that in Westminster Hall numerous times, and more times again in the main Chamber. I have heard him on many occasions and I admire his determination to discuss this subject matter and to make people aware of it—I congratulate him on that. The hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) made two significant interventions. Although she did not say so, I suspect they came from a place of personal knowledge.

As Members may be aware, while I am a father to three sons—my wife always wanted a wee girl, but it was just not going to happen—I work in an office with six female staff members and one male. I am certainly a lot more educated than I had been, and let us be honest, that understanding should not have taken that long. Gone should be the days of boys and girls being separated out to discuss those issues. The right hon. Member for Elmet and Rothwell mentioned that in both his introduction and summing-up. Those issues affect entire households and there should be a frank, honest and non-shameful understanding, which, frankly, does not take place at the moment.

The right hon. Member for Elmet and Rothwell referred to a story from one of his constituents which is like mine. When I married my wife, which will be 37 years ago on 6 June, the doctor told Sandra, “If you have a child, this will all go away.” Well, no it did not. Indeed, three boys later and it still had not gone away. My wife suffered with the condition over all those years, and only in the last three or four years, because of life-changing things, has it been slightly different.

I will refer to one of my staff members who suffers from endometriosis. I told the right hon. Member for Elmet and Rothwell beforehand that I was going to tell her story. I am not going to mention her name, because that would be the wrong thing to do, but I want to tell her story. It is a terrible story that she has been through. She was diagnosed in 2019 at the age of 24, after having been referred to gynae in 2012, seven years earlier. It took seven years to get the diagnosis. She has not yet been able to see an endometriosis consultant and she is now 29 years of age. That is 12 years, and she is still on the waiting list.

I thank the hon. Gentleman for giving way and I apologise for my late arrival, Ms Vaz. Does the hon. Gentleman agree that this is one of the fundamental problems? When we describe things as “women’s problems”, we are actually shying away from giving conditions and diseases the proper names that they have and, in so doing, are effectively avoiding an informed, intelligent discussion.

Yes, I absolutely agree with that. When people refer to “women’s problems”, they do not bring into the open the painful issue; they almost push it aside. The right hon. Lady is absolutely right to make that point. It is an issue that deserves medical attention, and significant attention at some times. We need to encourage medical students to take up this speciality by providing help with tuition, as has been done in colleagues’ constituencies in Wales. I understand that Wales has done some of these things. There has been a shortage of physiotherapists and other things. Therefore the question I ask the Minister—I am ever mindful that he is always responsive to the questions we ask, and we appreciate that because it makes our job of putting questions to him a wee bit easier when we know we are going to get a decent answer—is this. How do we encourage medical students to take up this speciality? We do so by normalising the conversation around reproductive health and by removing boundaries to conversations. That must start in education, at the very beginning—at school level, secondary school level, and college level—and the conversation should then continue right through life. That is what the right hon. Member for Elmet and Rothwell is asking for, and I support him.

I will finish with this comment. The NHS is failing young women, but more than this, it is failing families. We do a disservice by taking a silent stance. It is right that today we bring endometriosis out of the silence and into the conversation, but only if action follows.

It is a pleasure to serve with you in the Chair, Ms Vaz. I congratulate the right hon. Member for Elmet and Rothwell (Sir Alec Shelbrooke) on securing this incredibly important debate on this incredibly important topic. He has campaigned tirelessly on the subject over many years, and he spoke incredibly passionately today, sharing very painful testimonies but really shining a spotlight on endometriosis and, in particular, highlighting how workplaces, Governments and schools can all provide better support to those experiencing the condition.

As the right hon. Gentleman rightly set out, endometriosis can be an incredibly challenging condition to live with and can impact every aspect of a person’s life. There is no way of preventing it, and its cause is not yet understood, yet it affects around one in 10 women in the UK. As he rightly pointed out, that means that on average at least one girl in every classroom will go on to experience it. The symptoms can start very early on in adolescence.

Thinking of the disease primarily as a barrier to pregnancy or as simply making a girl’s or woman’s periods more painful is a gross oversimplification and, in many cases, incredibly inaccurate, which is why this debate is so crucial. The disease can vary widely in severity in the way it manifests. For example, 12% of endometriosis cases target women’s lungs and can cause symptoms beyond chronic pain—symptoms that can shatter a woman’s confidence and have a debilitating effect on her mental health. Endometriosis can also cause chronic bowel and bladder-related symptoms. That can lead to depression, which the right hon. Gentleman has also highlighted.

It would be remiss of me not to mention the fact that endometriosis continues for many people after the menopause. It is not a disease just for women who menstruate; it can continue after the menopause, and it can start before menstruation. As the hon. Lady points out, this disease is not restricted to gynaecology.

The right hon. Gentleman once again demonstrates how incredibly knowledgeable he is about this issue, and how much that knowledge is lacking among the wider public and in this place. We are grateful to him.

It is so essential that young people are taught about their bodies in school, and that they learn about not just relationships and sex, but health and wellbeing. That must include what is and is not normal throughout puberty, the menstrual cycle and hormones, to set young girls and young people up to live healthy lives, both mentally and physically.

The hon. Lady makes an important point about what is and what is not normal. When the Women and Equalities Committee did some work on women’s reproductive health, we got the message from various witnesses that they simply had no comprehension that their periods were not normal, because the message that they got from medics the whole time was, “You just have to get on with it.”

The right hon. Lady makes an important point—her Committee has done so much important work in this area—and it points to the importance of our education system in combating misunderstandings and providing people with the knowledge that they need to be armed with in order to manage what they and those around them will experience through life.

Sex education has been compulsory in English schools since 2017 and initially covered broad elements of sexual and reproductive health. After many years of campaigning, it was revised in 2020, and since then both boys and girls in state schools have been taught about periods and menstrual wellbeing. Of course, as with the rest of relationships, sex and health education, resources need to be tailored to the relevant age group. They need to be sensitive to a young person’s maturity and their needs.

The Government website states:

“Educating all pupils and students about periods is crucial to tackling the stigma which surrounds it.”

Labour very much agrees, and the next Labour Government will ensure that the curriculum taught in all state-funded schools reflects the issues and diversities of our society and ensures that all young people leave school ready for life.

We have already pledged to deliver, in government, an expert-led curriculum and assessment review, which will learn from international best practice and research across all areas, from history to health, to make sure that our curriculum is as strong and relevant as it can be. I look forward to hearing more from Members in this place and from stakeholders when the review gets started, to ensure that we pick up on the issues that have been identified in the debate today.

Part of that will require having enough teachers in the classroom to improve children’s outcomes and ensure that the curriculum can be delivered to every child as intended. Over the past few years, we have seen dire statistics on teacher recruitment, especially in secondary schools. That is why we have made tackling the recruitment and retention crisis a real focus and announced fully funded plans to deliver 6,500 more teachers to fill the gaps across the profession.