Refused the combined Pill - Help

[pillprobs]

I have been taking the combined pill for years, since I was 18 with two breaks to have my DCs. I have been on 3 different brands but on my current one for a few years now. It works really well for me, no side effects and fits my lifestyle.

I went to see the nurse this am for a repeat perscription and she told me she could not give me any as the guidelines have been changed by the doctor in charge of family planning at the surgery and I am over the weight guidelines for the combined pill!

I explained that I have been losing weight and am now 1 and a half stone lighter than when I last came for a prescription and they gave it to me then.

The nurse was very sympathetic and explained that only the doctor could give them to me if I could persuade her and has made me an appointment to see her in 2 weeks, next available appointment. She gave me a months supply as an emergency to tide me over.

She suggested I try the mini pill but as far as I am aware this is not as effective as the combined pill, has to be taken in a tighter time window and has side effects which are the reason I decided against it years ago!! I also know that overweight women are not advised to go on the minipill as risk of pregnancy is greater, something to do with absorbtion.

I am really angry, I understand that guidelines are for the patient but -

1. I am not new to the combined pill

1. Have no family history of blood clot or heart problems

1. Have taken it for years with no side effects

1. Have taken it whilst heavier than I am now

So, please can anyone give me any more advice on how to persuade the doctor to perscribe it at my appointment in two weeks.

I do not want to change from something that works well for me to something unknown for no good reason other than they changed the guidelines.

Thanks if you have read this far!

[Kayzr]

My GPs have never said anything to me about it and I am heavier than I should be.

[pillprobs]

Thanks Kayzr. Nurse did say that it was the guidelines for this surgery suggested by the doctor in charge of family planning not a government guideline.

My friend takes the combined pill and is considerably larger than me!

[financiallyscrewed]

I don't know what you should do about your doctor but; I'm on the mini pill and the 'rules' have changed in recent years.

You now take it like the combi pill (no set time limits etc) and it doesn't have as many side effects. Personally, I've had none whereas I got loads with the combi pill.

Saying that, other people get worse side effects with the single hormone one so I don't know if I'm lucky.

But, don't panic and explain your arguement rationally.

Good luck!

[pillprobs]

Thanks financially.

Wondered if any one else had been through the same thing?

I am quite rational and am able to argue my corner. I was just quite shocked to be refused, I suppose, but have no intention of changing my contraception so will argue my case!

[thumbwitch]

I had to go on the minipill because of clotting issues that were discovered late - the one I was on, Cerazette, doesn't have such a tight time frame as the older minipills, it has a few hours leeway. There is no withdrawal bleed as you take it all the time but I didn't particularly notice any worse side effects than I had from microgynon, which was my previous OCP. Minor loss of libido, that was it really.

It won't be the worst thing in the world if you can't persuade her, tbbh, although I would defend your right to have the OCP you want and are happy with.

[subtlemouse]

This is not a new thing: I had exactly the same experience after having DS (9 yrs ago!). I'd been on the combined pill for 15 yrs, no problems, no difficulty getting prescriptions. Then had infant and wham! too fat for combined pill. Moreover, too fat for mini-pill as well: dr said for it to be effective I would have to take TWO a day at exactly the same time. This was never going to happen.

Made do with the morning after pill for a few years (limited sex life with small child!!!) (which actually is a whole other infuriating story). Am I the only person who objects to having to justify her wish to purchase a perfectly legal medicine to a chemist who asks intrusive questions as if one were a delinquent schoolgirl instead of a 43yr old capable of making choices about her own fertility?

Finally got Mirena. No pills, no periods, more sex. Works for me.

But it is still incredibly annoying...

[pillprobs]

Thanks thumbwitch. That is the crunch really. I am a responsible 34 year old woman who has been made aware of the guidelines and can make an informed choice. As long as I have been offered all the information and an alternative, it is my right to choose to continue taking the combined pill.

I just hope the doctor is able to see it the same way! Will have to wait 2 weeks to find out now!

The ironic thing is that I finally decided to do something about my weight and am doing really well. Now they decide to take issue with it!

[pillprobs]

Thanks subtle. Very Frustrating. I will now worry about this for the next two weeks. Will have to look into family planning clinics in the area now, just in case. Would much rather get my contraception under the care of my G.P. I do not know the doctor the appointment is with but hope that they are sympathetic!

[pillprobs]

Hoping that someone else may have been told the same thing and managed to persuade their GP to give them the combined pill?

[emma1977]

Guidance has recently changed regarding combined pill and weight. We used to happily prescribe the combined pill for women with no other risk factors up to a BMI of 35. However, there is evidence of very siginifcantly increased risk of stroke/heart attacks/DVTs/PEs if a woman weighs over 30. Therefore,we should only be prescribing the combined pill for these women (BMI >30) in exception circumstances (i.e. if there is absolutely no other method suitable).

The mini pill would be a better choice. The traditional mini pills were more likely to fail in heavier women and had to be taken within 3hrs each day. Cerazette works in a slightly different way to older mini pills and is a lot more effective, even if you're overweight and has a 12hr window in which to remember it (same as combined pill).

Also, don't forget other methods- implant, coil, depo.....

Just a final word on 'persuading' your GP to prescribe- it is the GPs final decision not yours I'm afraid. If something were to happen to you as a result of an inadvisable prescribing decision, your GP would be wide open to litigation, even if YOU had pushed for something. BTW, family planning clinics are VERY strict on following presribing guidance regarding risk factors.

[pillprobs]

Thank you for the advice emma, I am assuming you are a G.P.

I do not want to go on the minipill and have already found a clinic that will prescribe the combined pill to me but would rather be under the care of my own G.P. surgery.

I just feel that it should be my choice to continue taking, what has for me been a successful choice of contraception.

What really annoyed me was the fact that I have lost weight and am continuing to do so. Nobody has ever mentioned my weight at the clinic not ever. Now I am finally doing something about it and doing very well they decide to make it an issue!! How about some support to lose weight?

I am intending to continue losing weight so am hoping the Gp will let me have the combined pill as I am doing well..

Of course, I could go away and starve myself, use laxatives or diet pills and lose the weight in a non healthy way and come back and get the pill then but am assuming the G.P would not advise that?!

[fluffles]

i have gone from combined pill to mini pill with no problems at all.

i have had migraines in the past which apparently put's me at greater risk of stroke on the combined pill (same as with being overweight)

anyway, i didn't want to change because i'd been 'fine' so far and was happy with my combined pill but if you think about it - the longer you are at 'greater risk' then the more likely you are to have the stroke...

on reflection it's just NOT worth it, it's like playing roulette betting on the same number each time - if the wheel is spun enough times then statistically the number will come up eventually.

oh, and the mini pill has been absolutely FINE too

[pillprobs]

Thanks fluffles, good to hear another point of view.

Have actually just found out I can buy the pill online from several different places. Obviously all legal etc. So will order tham online if the G.P. refuses to prescribe them!

Thanks for all your advice everyone.

[Vik08]

I have today been refused the combined pill due to bmi being too high for it (was okay on combined prior to my little one being born and now, sorry, can't have it)! Been prescribed mini pill, Cerazette, Desogestrel 75mcg. Doc unsure if i need to take double the doseage???!!!!! Can anyone help? Do I need to take 2 a day due to BMI being high or stick to 1 a day and keep my fingers crossed? Thank you :0)

[purplepeony]

If new evidence shows you are a higher risk, then the drs have to act within those guidlines.

You might weigh less now, but if your BMI is still between 30-35 ( and 1.5 stones will not reduce your BMI to

[lisab1993]

Need some help! I have never been on the pill before and wanting to go on it now and am worried I'll get refused as I'm overweight but i am on a diet and going to the gym will i be refused the pill please help thanks

[Rowgtfc72]

I'm fifteen stone and have been on the mini pill since I had DD eight and a half years ago.I was two stone heavier then. They do keep trying to push the coil onto me but I'm not budging!