For women west of the Shannon with suspected or confirmed endometriosis, the ritual of long-distance travel for treatment has become grimly familiar. The only two specialist centres capable of providing advanced investigation and excision surgery (the gold-standard international treatment) are in Tallaght University Hospital and Cork University Maternity Hospital. For anyone living in Galway, Mayo, Roscommon, Sligo or Donegal, the route to proper care is long, expensive and often unbearable.
Doctors in the West can diagnose, investigate and manage pain in general gynaecology clinics. They can prescribe hormonal medication, provide pain relief and refer patients to physiotherapy. But when the situation becomes complex, such as widespread lesions, deep infiltrating disease, severe pain affecting mobility, or the need for excision surgery, the system bends under its own limits. Those limits are exactly where these women’s lives begin to shrink.
The women who make these journeys describe months, sometimes years, of grinding pain. Days lost to bed. Missed lectures. Missed shifts. Cancelled nights out. Clothes bought a size up to accommodate the unpredictable bloating. Pads changed every half an hour. The ache, the nausea, the pins and needles. The quiet, persistent dread of the next month. Some recall collapsing in bathrooms. Others remember vomiting from pain in public toilets. The hurt becomes a geography of its own.
Yet even these stories rarely propel a woman to diagnosis. According to campaign groups, there are 300,000 women in Ireland living with endometriosis, and around 30,000 of them have complex cases, the kind requiring the surgical expertise available only in Tallaght or Cork. The West, an area covering almost half the country’s landmass, has no specialist centre yet fully staffed or operational.
The consequences ripple outward. Women in early stages of their careers burn through sick days. Students fall behind on coursework. Women caring for children or elderly parents scramble to arrange cover for overnight trips to Dublin. Some delay treatment altogether because they cannot bear the cost of travel or the physical toll of the journey. Others, unwilling to wait, go abroad. In 2024, The Journal reported that roughly 100 to 150 Irish women travelled to Romania for excision surgery, often paying thousands upfront.
“It’s not that women here are refusing care,” one Galway woman suffering from endometriosis told me. “It’s that the care doesn’t exist.”
“I cry myself to sleep sometimes, the pain is so bad. My social life is almost non-existent when I’m on my period, and I’ve lost count of how many sick days I’ve had to take.”
The HSE does not dispute the problem. They said plainly that there is a gap between demand and capacity. Galway University Hospital, it said, is “working with the National Women and Infants Health Programme to identify the resources needed for a multidisciplinary service,” including securing funding for a consultant gynaecologist with endometriosis expertise. A specialist physiotherapist, clinical nurse and clerical support are already in place, with recruitment underway for a psychologist and a dietitian.
But without a dedicated surgeon, the West cannot yet offer what Tallaght and Cork do. Women still travel. The buses and trains still fill. The early-morning journeys continue.
Against this backdrop, Minister for Health Jennifer Carroll McNeill has published Ireland’s first National Endometriosis Framework, a detailed clinical pathway intended to overhaul how the disease is recognised and treated. Central to the plan is a new “presumptive diagnosis” approach, designed to speed up clinical decisions so that women no longer spend years dismissed or misdiagnosed. The framework also arrives alongside a new financial support scheme for patients travelling abroad for treatment. Instead of paying thousands out of pocket and waiting months for reimbursement, patients will have their surgery and travel costs covered upfront, with the HSE paying approved international centres directly.
For campaigners, the framework is welcome, but it does not erase the urgency on the ground. Excision surgery is still carried out by too few clinicians in Ireland. Waiting lists remain long. And specialist access remains uneven.
But for women in the West — students, mothers, shift workers, carers, the gap remains real and immediate. Until a fully equipped specialist service arrives in Galway, the burden of distance is theirs alone to carry.
And so the early morning journeys continue: the buses, the painkillers in coat pockets, the bottles of water, the careful, slow steps onto the platform. Women travelling not for luxury or convenience, but for care that should exist much closer to home.
Emma van Oosterhout is the Editor-in-Chief of Student Independent News for 2025/26. She is studying MA Journalism at University of Galway, and graduated in 2025 with a BA in Global Media and History. She is from Corofin, Co. Galway. Emma was previously a News Editor for the year 2023/24. She has written for SIN since 2023.