Endometriosis UK is championing a new initiative called ‘Jess’s Rule,’ a crucial three-strikes-and-rethink approach designed to significantly accelerate the diagnosis of endometriosis, a debilitating gynaecological condition. On average, individuals suffering from endometriosis wait nearly nine years to receive a diagnosis after their initial GP visit—leaving millions of women in the UK enduring pain in silence and feeling disbelieved.

A comprehensive 2024 report by Endometriosis UK highlighted the severity of this issue, revealing that 47% of surveyed individuals reported visiting a GP ten or more times before finally being diagnosed.

Officially introduced on September 23, 2025, Jess’s Rule mandates that General Practitioners (GPs) must “reflect, review, and rethink” a patient’s case if they present with the same or worsening symptoms three times without a clear diagnosis or improvement.

This vital initiative is rooted in tragedy, named in memory of Jessica Brady, who at 27 years old succumbed to stage four breast cancer after her symptoms were dismissed over twenty times by her GP. She received a terminal diagnosis just three weeks before her death.

Endometriosis affects approximately 1.5 million women in the UK who have received a formal diagnosis, with potentially millions more living undiagnosed. The condition involves the growth of endometrial tissue, similar to the lining of the uterus, outside of the uterus itself, often on organs like the cervix, bladder, and ovaries.

This misplaced tissue thickens and accumulates during each menstrual cycle. When a woman has her period, the tissue also attempts to break down, leading to inflammation and the formation of scar tissue. These adhesions can bind and stiffen organs, causing excruciating pulling sensations and sharp, shooting pains. The pain can be so severe that it becomes debilitating. In some cases, the build-up of scar tissue blocks fallopian tubes or disrupts hormonal balance necessary for ovulation, making conception impossible.

The far-reaching impact of endometriosis on women’s quality of life is immense, hindering their ability to work, attend school, or engage in social activities. Tragically, there is no known cure. Current treatment options primarily focus on pain management or performing keyhole surgery to remove misplaced tissue and loosen scar tissue. In the most severe cases, a full hysterectomy may be considered as a last resort.

In light of the launch of Jess’s Rule, the Daily Mail shared the poignant accounts of three women who endured years of struggle to secure an endometriosis diagnosis. Though their stories differ, they collectively embody a shared hope that this new initiative will pave the way for earlier and more accurate diagnoses for others.

Elle Courtonel’s Journey: Two Decades of Pain Before Answers

Elle Courtonel, from Leicestershire, began experiencing debilitating period pain at the tender age of nine. It took her a staggering twenty years, marked by immense pain and frustration to finally receive her endometriosis diagnosis at 29, just weeks ago.

Her condition led to frequent school absences and deep isolation, as her friends had not yet started their periods. During her first GP visit, Elle was told she was too young for contraception. At 13, she was prescribed the pill to suppress her periods, but no further investigations were made to determine the cause of her agony. Instead, she was repeatedly told: “Just take Lactulose, painkillers, and the pill.”

Elle described her health journey as “a mess,” noting a significant deterioration over the last two years that left her struggling to climb stairs, suffering from chronic back pain, fatigue, anxiety, and depression. Her eventual diagnosis came after a private ADHD assessment led her to address gut health issues that revealed severe reactions to almost everything. This prompted more serious investigations—fit tests, colonoscopy, ultrasounds, and an MRI.

Unable to afford private consultations, Elle resorted to using ChatGPT to interpret her MRI results, which confirmed deep infiltrating stage 4 endometriosis. Reflecting on her experience, she said that an earlier diagnosis would have given her confidence, allowed lifestyle adjustments, and empowered her to make informed decisions sooner.

Sofia Spashett’s Battle: From School Toilets to Self-Catheterisation

Sofia Jade Spashett, from Southampton, began experiencing endometriosis symptoms at just twelve years old. During her first period, she cried in the school toilets from unbearable pain, feeling as though her insides were being twisted.

Despite her GP visits, she was told to “give her body time to adjust.” Her worsening symptoms and significant blood clots led her to A&E at age 12. Her mother—aware of a family history of endometriosis—persistently fought for her to be taken seriously.

After undergoing two MRIs, a CT scan, and internal scans, Sofia’s results showed little except two ruptured cysts. Yet, her pain persisted. Eventually, at 18, she was admitted to another hospital where she felt heard and finally received a diagnosis.

The condition profoundly disrupted her teenage years, preventing her from attending school or working. During severe flare-ups, Sofia is forced to self-catheterise due to the extreme bodily tension caused by pain.

She described the journey as “exhausting and isolating,” adding, “Getting a diagnosis took everything out of me—the constant battle to be believed, the endless appointments, the physical pain, and the emotional toll of being dismissed over and over again.” Yet, she said that finally being diagnosed validated her suffering and struggle for recognition.

Mini’s Story: Misdiagnosed and Dismissed Before the Truth Emerged

Mini, 28, from London, is now five weeks post-surgery after years of being dismissed by doctors. With a history of heavy periods and anaemia, she was initially misdiagnosed with Polycystic Ovary Syndrome (PCOS). Despite persistent symptoms such as exhaustion and chronic pain, her concerns were brushed aside.

GPs routinely prescribed iron supplements, which worsened her sensitive stomach. After persistent pleading, she finally received a scan where an ultrasound technician suspected endometriosis. Pursuing private care, doctors discovered extensive endometriosis on her right ovary, previously mistaken for cysts and PCOS.

Mini recalled, “Turns out, my pain was very real, very serious, and not at all normal.” She later learned that adhesions had spread near her liver, a pain she had long reported but was dismissed as acid reflux.

For years, she braced for disappointment before every appointment. Reflecting on her journey, Mini said, “At the end of the day, what we will remember is not that the GP didn’t know what was wrong with us, but that they believed us and found a way to help us.”

Endometriosis UK has expressed profound hope that Jess’s Rule will support the at least 1.5 million women already diagnosed and many more still awaiting answers. The charity stated: “We hope that the creation of Jess’s Rule provides some comfort to the family and friends of Jessica Brady, and that it is actively embraced by GPs so that people with serious conditions do not suffer unnecessarily and get a diagnosis and appropriate help as soon as possible.”