Minister for Health launches Ireland’s First National Endometriosis Framework
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From: Department of Health
- Published on: 18 October 2025
- Last updated on: 18 October 2025
The Minister for Health, Jennifer Carroll MacNeill, TD, has today launched the National Framework for the Management of Endometriosis in Ireland, marking an important milestone in the evolution of women’s healthcare in Ireland. The framework establishes for the first time a defined clinical care pathway for women and girls living with endometriosis.
Developed by the Health Service Executive’s (HSE) National Women and Infants Health Programme (NWIHP), the framework reflects the voices of patient advocates and aims to transform how endometriosis is recognised and treated across the country. Central to the Model of Care is the principle of presumed diagnosis, proposing that a woman presenting with symptoms should be treated on the presumption that she has endometriosis. This model acknowledges that women are the most reliable narrators of their own symptoms and pain and reduces delays in the management of symptoms as well as the overall impact of this disease on women.
The care pathway spans primary care to secondary care and complex tertiary care. Moderate cases will be treated in five regional specialist centres. Three centres are already established in the Rotunda Hospital, the Coombe Hospital, and University Hospital Limerick, with two more in development at University Hospital Galway and the National Maternity Hospital. Complex cases will be referred to two supra-regional centres in Tallaght University Hospital and Cork University Maternity Hospital.
Joined today at the launch by HSE CEO, Bernard Gloster and the Clinical Director of NWIHP, Dr Cliona Murphy, Minister Carroll MacNeill said:
“Endometriosis has long been an under-recognised and under-treated condition, but progress is now being made in raising awareness and enhancing our services. The HSE, the Department of Health and the clinical community are working as one to improve in a dedicated and sustained way how we support and treat women with endometriosis.
“The completion of the National Framework for the Management of Endometriosis in Ireland is an important step in providing a clear pathway for the management and treatment of this often-debilitating condition. It puts women’s experience of their symptoms at the centre. It will raise awareness in the clinical community, reduce time to diagnosis, and ensure timely and effective treatment.
“I am also committed to expanding our specialist endometriosis services, improving support services for women and promoting awareness of endometriosis, both among the public and within our health services.”
In addition to the launch of the Framework, Minister Carroll MacNeill has mandated several actions to accelerate access to care for women affected by this debilitating condition.
- The HSE will increase the number of surgeries over the coming months and will carry out more than 100 additional surgeries for women waiting for treatment across all regions.
- An additional colorectal surgeon has been advertised for recruitment by the HSE and will serve to facilitate and increase capacity for more complex surgical treatments.
- The HSE is supporting women with access to treatment abroad. Information on how to apply, including a dedicated email address, is available at hse.ie/endometriosisabroad
- An Endometriosis Advisory Group, with membership from patient advocates and the Women’s Health Taskforce, has been established and will meet soon to advise on specific actions in relation to endometriosis.
- To improve education and training, international endometriosis experts will be invited to collaborate and engage with our clinicians to improve treatment options, build expertise and share learnings. This will serve to build ongoing and enduring relationships with international experts in this field.
- In conjunction with the publication of the framework, we will be communicating with all GPs, consultants and other clinicians to raise awareness of endometriosis in their clinical assessments.
- A national awareness campaign will also be developed around menstrual health, including endometriosis, early next year.
HSE CEO, Bernard Gloster, said:
“While endometriosis care in Ireland has historically been challenging, it is encouraging to see patients, clinicians, advocacy groups and government come together to welcome the important progress announced today. As part of Ireland’s first National Framework for the Management of Endometriosis, we are making a commitment to improving access to surgical care for women affected by the condition across the country.
“Over the coming months, the HSE will deliver more than 100 additional surgeries, significantly improving access to treatment for those who have been waiting. To further expand capacity, we are recruiting an additional colorectal surgeon to support more complex procedures and setting up an Endometriosis Surgery Abroad Interim Scheme to operate in parallel with services in Ireland. This new scheme is a targeted response to the urgent need for timely surgical intervention for women with moderate to severe endometriosis, while domestic services are further developed and scaled up under the National Endometriosis Framework.”
Clinical Director of NWIHP, Dr Cliona Murphy said:
“This Endometriosis Framework has been the culmination of years of work by committed clinicians and advocates in this country. We are one of few countries who have such a document.
“The framework provides a structured approach to help clinicians provide quality clinical care for women dealing with this difficult condition.
“Much progress has occurred in this space, and this is a roadmap for future improvements. We hope to build on this framework to reduce diagnostic and wait times and raise awareness of the available services.”
The National Framework for the Management of Endometriosis in Ireland is available here.
Notes
What is endometriosis?
Endometriosis is among the most prevalent health conditions affecting women in Ireland, for which currently, there is no known cure.
The exact number of women who have endometriosis is unknown but recent research estimates that it many affect as many as one in seven women.
This chronic condition is difficult to diagnose and treat because of the variation of presentations, impacting the physical and mental wellbeing of women.
It is characterised by a growth of endometrium-like cells outside the uterus. While its precise cause is unclear, it’s understood to be a hormone-mediated condition and occurs during a woman’s reproductive years.
Symptoms of endometriosis can vary in number and severity, but can include pelvic pain, menstruation pain, fatigue, diarrhoea, constipation, bloating and nausea.
Establishment of specialist centres
Specialist regional centres, which provide interdisciplinary care to women with moderate stages of endometriosis, have been established in the Rotunda Hospital, the Coombe Hospital, University Hospital Limerick (UHL), with clinics under development in University Hospital Galway (UHG) and the National Maternity Hospital (NMH).
Women with complex cases can be referred to two tertiary specialist centres in Dublin (Tallaght Hospital) and Cork (Cork University Maternity Hospital).
Treatment including surgical intervention is being provided across the specialist centres.
Over 1,150 new patients were seen through our specialist endometriosis services in 2024 and over 600 patients were seen in the first half of this year.
Endometriosis and Fertility
It is estimated that 47% of women who experience fertility issues have endometriosis. In many cases, endometriosis may only be suspected or diagnosed when a woman undergoes fertility investigations.
Fertility care has also benefited from targeted investment from Government. There are now six regional public fertility hubs across Ireland. These hubs accept referrals from GPs directly and from consultants. Women with suspected or confirmed endometriosis are exempt from the standard referral criteria and get early access to fertility care. This integrated model allows for streamlined referrals between fertility and endometriosis services, ensuring women receive timely and appropriate care based on individual needs.
Diagnosis of Endometriosis
The National Institute for Health and Care Excellence (NICE) Guideline endorses laparoscopic surgery as the definitive mode of diagnosis for endometriosis. However, the Model of Care proposed in the National Endometriosis Framework is that a woman presenting with symptoms of endometriosis should be treated on the presumption that she has endometriosis. The primary objective of working with a presumptive diagnosis is to reduce delays in the management of the associated side effects and the overall burden and impact of this disease on women. This also means that a definitive diagnosis is not required for GPs to refer to specialist services. In many cases, where treatment improves or resolves symptoms, further tests will not be necessary. For some women, further investigations and treatment, for example in the form of a laparoscopy, may be medically necessitated at a later stage.
Staging systems
Staging and classification systems play an important role in the clinical management of endometriosis. They describe the extent and distribution of disease and create a common clinical language, ensuring that practitioners can speak a shared language when diagnosing and treating endometriosis. While the most widely used staging system for describing the extent of endometriosis includes four stages, ranging from minimal to severe, these stages do not always correlate to the level of pain or morbidity experienced by a woman. Some women may require more specialised, multi-disciplinary care that may not correlate to the clinical staging assigned to their endometriosis but rather is informed by their experience of this disease and the impact on their day-to-day lives.
Government funding and support
The Government is committed to promoting and improving women’s health outcomes. The Programme for Government commits to continue to expand specialist services in endometriosis. Endometriosis has been recognised as part of the work of the Women’s Health Taskforce and is included in the Women’s Health Action Plan 2024/25.
Funding of over €5 million has been invested in endometriosis services since 2021, including more than €2 million full year costs this year to further develop the services.