Title: Navigating Healthcare in Higher Education for Students with Gynaecological Pain: An
exploratory survey
Version: 2 Date: 26 May 2025
Reviewer's report:
This manuscript presents an important and timely exploration of how gynaecological pain affects
university students’ engagement in higher education and their access to healthcare. It contributes
meaningfully to a neglected area in women’s health and education research, particularly in
highlighting the intersection between undiagnosed or poorly managed pain and academic
disruption. The mixed-methods design is a strength, and the qualitative findings give rich insight
into lived experiences. However, the discussion and framing of the findings require revision and
expansion to align more deeply with relevant clinical literature and better contextualise the study
within broader discourses on gynaecological pain, diagnosis, and management. Moreover, while
the qualitative findings are compelling, the manuscript would benefit from greater conceptual
clarity, more precise language, and a tighter synthesis of themes.
1. The discussion lacks sufficient engagement with clinical understandings of gynaecological
pain, particularly in relation to postoperative or chronic pain management strategies. Recent
literature offers deeper insight into how pain can persist and affect functional ability and quality
of life, including within academic settings. A particularly relevant study is:  DOI: 10.1016/
j.jmig.2024.10.030
This study systematically reviews postoperative pain control strategies, comparing TAP blocks
and wound infiltration. Its findings on variations in pain intensity and duration based on
anesthetic technique would substantially enhance this manuscript’s discussion on pain as a
recurring barrier to student functioning.
2. While the thematic findings are well-presented, the discussion often reiterates the results
instead of critically interrogating them. For instance:
• The influence of age and gender identity in healthcare experiences is underexplored
theoretically.
• The finding that students “feel more in control at home” could be discussed using frameworks
of medical agency or institutional trust.
Consider linking your findings with literature on patient-centred care, health-seeking behaviour
in adolescents and young adults, and stigma in medical discourse, to deepen the analysis.
Concepts from medical sociology and gender studies could be helpful.
3. While the Women’s Health Strategy (WHS) and Primary Care Recovery Plan are referenced,
the discussion could go further in proposing policy and practice-level recommendations for:
• University accommodations frameworks
• Digital access to healthcare for mobile student populations
• Campus-based awareness programs
Strengthen the recommendations section by clearly connecting findings to institutional actions
and specific aspects of WHS implementation.
This is an important study with strong methodological grounding and valuable insights. With
targeted revisions to the discussion, stronger conceptual framing, and better integration of
clinical evidence, this manuscript will make a significant contribution to both women’s health
and higher education literature.
RECOMMEND: MAJOR REVISION