A rapid evidence map of womens health

The rapid evidence map focuses on identifying the nature and extent of published literature on the following topic areas: healthcare professionals communication with women about womens health issues and broader health problems during clinical encounters; access to specialist healthcare; endometriosis; menopause; womens health and mental health issues, and mental health issues associated with specific conditions related to menopause or menstrual health (adenomyosis; endometriosis; fibroids; heavy menstrual bleeding, polycystic ovary syndrome and premenstrual dysphoric disorder). The purpose of this rapid evidence map was to identify research gaps and priorities that will be beneficial to womens health in Wales. The rapid evidence map uses abbreviated systematic mapping or scoping review methods to provide a description of the nature, characteristics and volume of the available evidence. There is a lack of primary and secondary research that explores communication between women and healthcare professionals within primary and secondary care settings. Secondary research evidence exists but there are gaps in the evidence base regarding access to services providing minor gynaecological procedures and pain management, or care for menstrual health and wellbeing, endometriosis, polycystic ovarian syndrome, menopause, heart conditions, autoimmune diseases, hypermobility spectrum disorders, myalgic encephalomyelitis, long COVID, fibromyalgia, skin conditions, or palliative and end of life care, which are priority areas identified by the Womens Health Wales Coalition (2022). There are no active funding calls exploring these topics. Regarding endometriosis, there is a lack of review evidence regarding education and resources for health care professionals and doctors to reduce diagnostic times and improve care. There is an evidence gap for primary research regarding information, support interventions and tools for women with endometriosis to help them manage their symptoms and improve their quality of life. A substantial amount of secondary evidence exists on menopause along with a plethora of research priorities around treatment and symptom management. It was beyond the scope of this work to determine if any research had been conducted in these priority areas since the production of the guidelines and recommendations. There is a lack of research recommendations and review evidence that address mental health issues and specific issues that affect a womens menstrual health such as adenomyosis, fibroids, heavy menstrual bleeding and premenstrual dysphoric disorder. Funding statement The Wales Centre for Evidence Based Care was funded for this work by the Wales COVID-19 Evidence Centre, itself funded by Health and Care Research Wales on behalf of Welsh Government. #### Rapid Evidence Map Details #### Review conducted by Review conducted by Wales Centre For Evidence Based Care #### Review Team Review Team ##### Review submitted to the WCEC Review submitted to the WCEC October 2022 ##### Stakeholder consultation meeting Stakeholder consultation meeting 24th October 2022 ##### Rapid Evidence Map report issued by the WCEC Rapid Evidence Map report issued by the WCEC November 2022 #### WCEC Team WCEC Team #### This review should be cited as This review should be cited as REM00045. Wales COVID-19 Evidence Centre, Rapid Evidence map: Womens health. October 2022 #### Disclaimer Disclaimer The views expressed in this publication are those of the authors, not necessarily Health and Care Research Wales. The WCEC and authors of this work declare that they have no conflict of interest. TOPLINE SUMMARY #### What are Rapid Evidence Maps? What are Rapid Evidence Maps? Our Rapid Evidence Maps (REMs) use abbreviated systematic mapping or scoping review methods to provide a description of the nature, characteristics and volume of the available evidence for a particular policy domain or research question. They are mainly based on the assessment of abstracts and incorporate an a priori protocol, systematic search, screening, and minimal data extraction. They may sometimes include critical appraisal, but no evidence synthesis is conducted. Priority is given, where feasible, to studies representing robust evidence synthesis. They are designed and used primarily to identify a substantial focus for a rapid review, and key research gaps in the evidence-base . ( N . B. Evidence maps are not suitable to support evidence-informed policy development, as they do not include a synthesis of the results .) #### Who is this summary for? Who is this summary for? Health and Care Research Wales #### Background / Aim of Rapid Evidence Map (REM) Background / Aim of Rapid Evidence Map (REM) The Welsh Government Research and Development Division intends to run a commissioned funding call on understanding and tackling gender inequalities in health and social care in Wales. The purpose of this REM was to identify research gaps and priorities that will be beneficial to women’s health in Wales to inform the proposed funding call. It was decided, based on a preliminary review of the literature, feedback from an NHS public consultation exercise in Wales, and further discussion with the stakeholder group, that the REM would focus on identifying the nature and extent of the literature on the following prioritised topic areas: healthcare professionals’ communication with women about women’s health issues and broader health problems during clinical encounters; access to specialist healthcare ; endometriosis ; menopause ; women’s health and mental health issues, and mental health issues associated with specific conditions related to menopause or menstrual health (adenomyosis; endometriosis; fibroids; heavy menstrual bleeding, polycystic ovary syndrome and premenstrual dysphoric disorder). Research gaps in other areas and health conditions, in which women might also experience inequality, were not explored in this REM. #### Key Findings ##### Extent of the evidence base Extent of the evidence base ##### Recency of the evidence base Recency of the evidence base #### Summary of the evidence gaps Summary of the evidence gaps ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The Wales Centre for Evidence Based Care was funded for this work by the Wales COVID-19 Evidence Centre, itself funded by Health and Care Research Wales on behalf of Welsh Government. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present work are contained in the manuscript The datasets generated during and/or analyzed during the current study are available from the corresponding author following reasonable request. * Acronym : Full Description BMA : British Medical Association DHEA : Dehydroepiandrosterone DHSC : Department of health and Social Care FTWW : Fair Treatment for The Women of Wales GSM : Genitourinary syndrome of menopause HCP : Health care professionals HCRW : Heath and Care Research Wales HIC : High income countries HRT : Hormone replacement therapy HMB : Heavy menstrual bleeding IPV : Intimate partner violence NICE : National Institute of Clinical Excellence NIHR : National Institute for Health and Care Research OECD : Organisation for Economic Co-operation and Development PCOS : Polycystic ovary syndrome PMDD : Premenstrual dysphoric disorder PMS : Premenstrual syndrome REM : Rapid Evidence Map VMS : Vasomotor symptoms VTE : Venous thromboembolism LNG-IUS : Levonorgestrel-releasing intra-uterine system