Addressing Medical Misogyny in Gynaecology: The role of the WID-easy Test

Hannah Hunt
3 days ago
2 min read

BMJ Feature: Medical misogyny and “harrowing” experiences: what are doctors doing to improve outpatient gynaecological procedures?

Adele Waters, BMJ 2025

Outpatient gynaecological procedures, particularly hysteroscopy and endometrial biopsy, remain central to the investigation of abnormal uterine bleeding (AUB) and suspected endometrial cancer. However, a recent BMJ feature brings attention to an issue many clinicians recognise, but services have historically struggled to address: the significant physical and psychological burden these procedures can impose on women.

The article situates painful outpatient procedures within a wider conversation about informed consent, patient autonomy, and long-standing gender bias in healthcare, drawing on both patient testimony and professional reflection. For gynaecology teams working under increasing diagnostic pressure, it raises an important question: how do we maintain diagnostic rigour while minimising harm to women and AFAB patients?

Pain in outpatient gynaecology

National data show that outpatient hysteroscopy is well tolerated by many women. However, audit and campaign data cited in the BMJ article demonstrate that a substantial minority experience severe pain, with some describing procedures as traumatic.

Of particular concern are reports of:

Women not being adequately counselled about the potential for pain
Requests to stop procedures not being honoured
Alternatives, including inpatient procedures under anaesthesia, are not always clearly discussed

This persists despite updated RCOG guidance on outpatient hysteroscopy, which emphasises informed decision-making, pain mitigation strategies, and patient choice.

While improvements in technique, equipment, and analgesia are essential, the article highlights a critical reality: even best-practice hysteroscopy will not be appropriate or acceptable for every patient.

Rethinking the diagnostic pathway for AUB - The WID-easy Test

Later this year, consultant gynaecological oncologist Dr. Adeola Olaitan will begin offering the WID-easy test to private patients. The simple swab test analyses DNA methylation markers associated with endometrial cancer. When compared to transvaginal ultrasound, the current gold-standard method of triage, the WID-easy test has been shown to reduce unnecessary follow-up procedures such as hysteroscopy by >90% whilst detecting the same number of cancers 1.

Importantly, the test may also address known limitations of transvaginal ultrasound, including reduced sensitivity in detecting endometrial cancer in Black women, particularly for poorer-prognosis subtypes.

Implications for services and patients

From a service perspective, the ability to confidently triage endometrial cancer risk using a minimally-invasive test could have several downstream benefits:

Fewer women undergoing unnecessary hysteroscopy and other painful procedures
Greater capacity to prioritise hysteroscopy under anaesthesia for those who truly need it
Improved patient experience without compromising cancer detection

Looking Ahead - WID-easy in the NHS

The WID-easy test has now been accepted onto the NHS Innovation Accelerator programme with several NHS pilots currently underway, reflecting its potential to reshape gynaecological cancer pathways.

By adapting current clinical pathways, the WID-easy test helps to establish a near future where:

cancer is detected early and accurately
women are spared unnecessary pain and anxiety
service efficiency and patient experience are both improved

Learn more about the WID-easy test here.

References

Evans, Iona et al. Performance of the WID-qEC test versus sonography to detect uterine cancers in women with abnormal uterine bleeding (EPI-SURE): a prospective, consecutive observational cohort study in the UK. The Lancet Oncology, Volume 24, Issue 12, 1375 – 1386.