English: The task and finish group's report did, however, recommend research in a number of other areas, including the development of an effective symptom awareness tool, evaluation of the follow-up processes after surgery, a multidisciplinary approach to symptom management, development of educational resources, and ongoing monitoring of patient outcomes to understand if we are being more successful. I agree that that is something that should be taken forward by the women's health group, and also Health and Care Research Wales, to help identify the availability of research funding for these endometriosis-related questions. Again, the women's health group should consider this action through their endometriosis-specific work. In relation to the recommendation regarding schools and ensuring that pupils are made aware of normal menstrual health, I agree with many of the comments that were made. Thinking back to my own experience as a teenage boy, growing up and going to school, this was never mentioned in anything other than very mechanical terms, as far as boys were concerned. The new curriculum for Wales guidance is clear that growing up has a critical impact on learners' health and well-being. So, schools and other settings need to consider how to support learners to understand and manage these developmental changes, as well as how those changes affect learners in a range of different ways. The health and well-being area of learning and experience recognises that there are a range of conditions that affect learners that they need to be able to recognise, understand, and seek help for. Within the new curriculum, schools are given the flexibility to cover puberty and menstruation at a developmentally appropriate stage, and to provide learners with the knowledge and confidence to seek support and help deal with the physical and emotional changes that occur through life. The education Minister commissioned a relationships and sexuality education working group to include a range of stakeholders and practitioners. That group is focusing on developing an RSE code and supporting guidance that will form part of the new curriculum framework. I expect that group to consider issues such as menstrual well-being as part of their work. The women's health implementation group is working to produce learning resources around menstruation to better equip young people to understand what constitutes a normal period, and when to seek medical advice. This is an important piece of work and consistent with one of the major recommendations from the endometriosis task and finish group. That stressed the importance of early education about endometriosis and menstruation. The task and finish group's report stated that a key factor that causes delay and poor outcomes for women with endometriosis is that there are a significant number of gynaecologists who do not consider that they have the necessary skills to excise endometriosis lesions completely. Most gynaecologists will instead undertake diagnostic laparoscopy and then offer medical management; or, alternatively, ablate the endometriosis lesions. These approaches result in repeated treatments and surgery. I want to reiterate that health boards need to emphasise the appropriate pathway to enable early diagnosis before specialist intervention is required. I am concerned that a condition that affects around one in 10 women is currently considered something that can only be treated by specialists. I expect the women's health group to consider this issue, together with the Royal College of Obstetricians and Gynaecologists and Health Education and Improvement Wales, to discuss the appropriate level of training provided to gynaecologists to enable them to deliver the necessary intervention when a woman presents to them with early endometriosis. Specialists should only be required when the disease has progressed too far and becomes more complicated. I will be writing to health boards to remind them of their obligations, and to seek further assurance that gynaecology services will offer the full range of treatments required by their population. To conclude, I want to reaffirm my commitment, and the Government's commitment, to all aspects of women's health, and in particular to care for those women whose lives are affected by endometriosis, and their families and friends. As I've outlined, we are working to increase levels of awareness of menstruation in young people, and to enable girls to seek medical advice when necessary and at the earliest possible stage. I expect health boards to plan for and deliver the full range of gynaecology services required to comply with NICE guidance. In finishing, I would say this: if the same number of men lived with the same discomfort that endometriosis causes, then I do not believe that the health service response would need the further improvement today that is still plainly required. We have made some progress in the last three years, but we have a great deal more to do.
Welsh: Fodd bynnag, argymhellodd adroddiad y grŵp gorchwyl a gorffen ymchwil mewn nifer o feysydd eraill, gan gynnwys datblygu offeryn effeithiol i godi ymwybyddiaeth o symptomau, gwerthuso'r prosesau dilynol ar ôl llawdriniaeth, dull amlddisgyblaethol o reoli symptomau, datblygu adnoddau addysgol, a monitro canlyniadau cleifion yn barhaus er mwyn deall a ydym yn fwy llwyddiannus. Cytunaf fod hynny'n rhywbeth y dylai'r grŵp iechyd menywod, a hefyd Ymchwil Iechyd a Gofal Cymru, ei ddatblygu, i helpu i nodi'r cyllid ymchwil sydd ar gael ar gyfer cwestiynau'n ymwneud ag endometriosis. Unwaith eto, dylai'r grŵp iechyd menywod ystyried y cam gweithredu hwn drwy eu gwaith sy'n canolbwyntio'n benodol ar endometriosis. O ran yr argymhelliad ynglŷn ag ysgolion a sicrhau bod disgyblion yn cael gwybod am iechyd mislif arferol, cytunaf â llawer o'r sylwadau a wnaed. Gan feddwl yn ôl at fy mhrofiad fy hun fel bachgen yn ei arddegau, yn tyfu i fyny ac yn mynd i'r ysgol, mewn termau mecanyddol iawn yn unig y soniwyd am hyn wrth y bechgyn. Mae canllawiau'r cwricwlwm newydd i Gymru yn glir fod tyfu i fyny'n cael effaith sylfaenol ar iechyd a lles dysgwyr. Felly, mae angen i ysgolion a lleoliadau eraill ystyried sut i gynorthwyo dysgwyr i ddeall a rheoli'r newidiadau datblygiadol hyn, yn ogystal â sut y mae'r newidiadau hynny'n effeithio ar ddysgwyr mewn amryw o wahanol ffyrdd. Mae maes dysgu a phrofiad iechyd a lles yn cydnabod bod amryw o gyflyrau'n effeithio ar ddysgwyr a bod angen iddynt allu eu hadnabod, eu deall a gofyn am gymorth ar eu cyfer. Yn y cwricwlwm newydd, rhoddir hyblygrwydd i ysgolion ymdrin â'r glasoed a mislif ar gam sy'n briodol yn ddatblygiadol, ac i roi gwybodaeth a hyder i ddysgwyr ofyn am gymorth a helpu i ymdopi â'r newidiadau corfforol ac emosiynol sy'n digwydd drwy gydol ein bywyd. Comisiynodd y Gweinidog addysg weithgor addysg cydberthynas a rhywioldeb i gynnwys amrywiaeth o randdeiliaid ac addysgwyr. Mae'r grŵp hwnnw'n canolbwyntio ar ddatblygu cod addysg cydberthynas a rhywioldeb a chanllawiau ategol a fydd yn rhan o fframwaith newydd y cwricwlwm. Rwy'n disgwyl i'r grŵp hwnnw ystyried materion megis lles mislif fel rhan o'u gwaith. Mae'r grŵp gweithredu ar iechyd menywod yn gweithio i gynhyrchu adnoddau dysgu ar gyfer mislif er mwyn paratoi pobl ifanc yn well i ddeall beth sy'n fislif arferol, a phryd i ofyn am gyngor meddygol. Mae hwn yn waith pwysig ac yn cyd-fynd ag un o brif argymhellion y grŵp gorchwyl a gorffen ar endometriosis. Roedd hwnnw'n pwysleisio pwysigrwydd addysg gynnar ynghylch endometriosis a mislif. Nododd adroddiad y grŵp gorchwyl a gorffen mai un ffactor allweddol sy'n achosi oedi a chanlyniadau gwael i fenywod ag endometriosis yw bod nifer sylweddol o gynaecolegwyr o'r farn nad oes ganddynt yr holl sgiliau sydd eu hangen i dynnu briwiau endometriosis. Bydd y rhan fwyaf o gynaecolegwyr yn cyflawni laparosgopi diagnostig yn lle hynny ac yna'n cynnig rheolaeth feddygol; neu fel arall, yn lleihau'r briwiau endometriosis. Mae'r dulliau hyn yn arwain at driniaethau a llawdriniaethau dro ar ôl tro. Hoffwn ailadrodd bod angen i fyrddau iechyd bwysleisio'r llwybr priodol er mwyn ei gwneud hi'n bosibl rhoi diagnosis cynnar cyn bod angen ymyrraeth arbenigol. Rwy'n pryderu bod cyflwr sy'n effeithio ar tua un o bob 10 menyw yn cael ei ystyried yn rhywbeth na ellir ond ei drin gan arbenigwyr. Rwy'n disgwyl i'r grŵp iechyd menywod ystyried y mater hwn, ynghyd â Choleg Brenhinol yr Obstetryddion a'r Gynaecolegwyr ac Addysg a Gwella Iechyd Cymru, i drafod y lefel briodol o hyfforddiant a ddarperir i gynaecolegwyr i'w galluogi i ddarparu'r ymyrraeth angenrheidiol i fenyw ag endometriosis cynnar. Ni ddylai fod angen arbenigwyr ac eithrio pan fydd y clefyd wedi datblygu'n rhy bell ac wedi mynd yn fwy cymhleth. Byddaf yn ysgrifennu at y byrddau iechyd i'w hatgoffa o'u rhwymedigaethau, ac i ofyn am sicrwydd pellach y bydd gwasanaethau gynaecolegol yn cynnig yr ystod lawn o driniaethau sydd eu hangen ar eu poblogaeth. I gloi, rwyf am ailddatgan fy ymrwymiad, ac ymrwymiad y Llywodraeth, i bob agwedd ar iechyd menywod, ac yn arbennig i ofalu am y menywod y mae endometriosis yn effeithio ar eu bywydau, a'u teuluoedd a'u ffrindiau. Fel rwyf wedi amlinellu, rydym yn gweithio i gynyddu lefelau ymwybyddiaeth o'r mislif ymhlith pobl ifanc, ac i alluogi merched i ofyn am gyngor meddygol pan fo angen ac ar y cam cynharaf posibl. Rwy'n disgwyl i fyrddau iechyd gynllunio ar gyfer, a darparu'r ystod lawn o wasanaethau gynaecolegol sydd eu hangen i gydymffurfio â chanllawiau NICE. Wrth orffen, rwyf am ddweud hyn: pe bai'r un nifer o ddynion yn byw gyda'r un anghysur y mae endometriosis yn ei achosi, ni chredaf y byddai ymateb y gwasanaeth iechyd yn galw am y gwelliant pellach heddiw, ac mae'n amlwg fod galw amdano o hyd. Rydym wedi gwneud rhywfaint o gynnydd yn ystod y tair blynedd diwethaf, ond mae gennym lawer mwy i'w wneud.