Dr. Geraldine Canny:

I thank the Deputy. That is a very relevant question. Without research and innovation, the necessary process on diagnosis, surgical and other non-medical therapies will not be discovered. Strong research is being carried out in the UK, the US, Germany and France. I note that little research on this topic is being carried out in Ireland currently. In those contexts, there are faculty members with teams, including post-doctoral researchers, technicians and staff with close links with the clinical environment and clinicians to obtain samples, who are working together. Progress in the field is slow due to poorly designed studies, for example, clinical trials without a comparator and studies using poorly matched controls, so they are not reliable and reproducibility is not there.

A universal problem is the dearth of funding for research. In several systems, diagnostic areas or therapeutic areas such as gastrointestinal disease benefit from a higher level of funding and investment in research than women's health and endometriosis. Given certain difficulties with respect to diagnosis, the complexity of the pathology and the recurrent nature of the disease, this is very much merited. As I previously mentioned, no marker has been identified to date that is sensitive and specific enough to diagnose endometriosis from a blood sample, for example. We are some years away from that. There has been a recent focus by certain companies on women's health and menstrual health more broadly, but again there are no major breakthroughs to report. Unfortunately, many of the medications used to treat endometriosis hamper the endocrine system, so they block oestrogen production or action and they also blunt the inflammatory response, which is the reason for the intense pain associated with the condition. However, I would say in general that a great deal more progress is needed on research and funding to go with it.