The feeling is a dull, stabbing, pulling, piercing or razor-sharp pain. Most women feel uncomfortable when they are menstruating. One in ten women in Switzerland has the experience of another type of pain that can also occur, which is persistent, cramping, and that painkillers can barely keep in check. Endometriosis is a chronic disease in which tissue similar to the lining of the uterus (endometrium) develops outside the uterus. The chronic disease can form foci (lesions) in the abdomen, on the ovaries, on the peritoneum, on the bladder or even on the intestines. We don’t know how cells similar to the uterine lining end up in those parts of the body. 

What is clear, however, is that in endometriosis, these cells also react to sex hormones outside the uterus and basically participate in the menstrual cycle. Thus, the endometriosis lesions build up with the menstrual cycle and are shed again at the end of it. The problem is that outside the uterus they cannot drain properly as they would with menstrual bleeding.
 

Deficit in diseases specific to women

However, the Swiss Federal Council acknowledged that this would be important in a report written this summer in response to the postulate “Strategy for the early detection of endometriosis” that was submitted to it. In its postulate from 2023, the Council of States Science, Education and Culture Committee asked the Federal Council for an answer to the question of how endometriosis is to be treated in Switzerland in terms of early treatment, raising awareness and research.

It takes an average of ten years for the chronic disease to be diagnosed. Early detection should be key, however, as endometriosis can spread further in the body with each menstrual cycle. In this report, the Federal Council has now recognised that targeted measures are needed to detect endometriosis at an early stage, to improve the quality of treatment and to close existing gaps in care.

A societal problem

The Federal Council has now introduced initial measures. Among other things, the Swiss Federal Quality Commission (FQC) was instructed to take women’s diseases into account as part of its strategic objectives. In addition to this, the Swiss Health Observatory (Obsan) and the Federal Office of Public Health (FOPH) must check whether the provision of care to those affected can be systematically represented. 

For the Federal Council, the chronic disease of endometriosis is “representative of existing structural deficiencies in the Swiss health system in dealing with diseases specific to women.” However, due to the constitutional system of competences, health professionals and institutions are still responsible for ensuring prompt and appropriate diagnosis and treatment.

The fact that endometriosis is much more than a “women’s problem” can be seen in Australia and France, which were the first countries to set up a national endometriosis plan. These plans aim to shorten the time to diagnosis, massively expand research and standardise medical care. According to French President Emmanuel Macron, the chronic illness is a problem not only for the women affected, but for society as a whole. Almost half of all women with an unfulfilled desire to become pregnant are affected by endometriosis.