PCOS just had to fight for a referral

[notamonkeysuncle]

I have PCOS and have had since a teenager which has never been managed well.
I recently started metformin with a GP prescription. I had two blood tests prior to this which showed no ovulation.
After reading various things I decided to ask for a referral to a specialist because there lots I don't understand and have many questions.
The GP just told me I had to wait for the next blood test 21 days after my next period which could be any time in the next 12 months then there is a 9 month waiting list to see a gynae.
I refused and really fought to be referred now because of the long wait.
Have I done the right thing? anyone with any experience?
I'm really quite upset about the GPs response and trying to put me off

[AttilaTheMeerkat]

Yes you did the right thing.

re this part of your comment:-
"The GP just told me I had to wait for the next blood test 21 days after my next period"

This was errant nonsense anyway given that with PCOS periods are highly irregular in nature. Also blood tests can be done according to calendar days so these can be done on the 2nd and 21st of each month in any case. No-one should have to wait for their next period to show up before having more blood tests done. PCOS is not a condition that should be messed around with in any way by GPs either.

I would also now look into changing GP practice if this one has not been of much previous use.

[notamonkeysuncle]

I was hoping you'd reply attila You commented on one of my threads previously and were a great help.

I've rang and complained and have arranged to speak to someone else tomorrow, someone who hopefully knows what their talking about!

Do you know if there are guidelines etc that I can quote if I have issues again?
I do have a DD from a previous relationship will this affect anything? She was a surprise pregnancy not planned

[lildottie]

I believe you can get a referral if there are indicators of infertility. to my mind a lack of periods would constitute just that. we were told referral after 2years if no indicators - dh bad sa so we got referred after 1 year. gp should do sa for your dh alongside referral but clinic will do if gp doesn't.

having dd will probably mean you won't get funded treatment but you should still get tests. not sure if you'd get clomid or would have to find that yourself. hopefully someone else can answer that.

[notamonkeysuncle]

Ive just read the NICE guidelines and it looks like we'll be able to get some help just not the full amount (as we would if I had no children).
I'm looking at the positive that I've got a dc who was concieved naturally so hopefully will happen again with the help of metformin.
Im just desperate for the referral as I have so many questions and I don't feel like the GP is doing anything.
One blood test surely isn't enough

[Rumplestrumpet]

Sorry you've been going through this OP, it's tough. Just wanted to say you are absolutely right to push for referral - some GPs are very unsympathetic about fertility issues, and indeed often don't really know that much about it (hence the nonsense of a cd 21 blood test when your cycles are all over the place). If you have the strength for it, keep pushing until someone listens. It really shouldn't be that way, of course!

Best of luck.

[notamonkeysuncle]

UPDATE
I have just spoken to a different GP, he's said that he'll happily refer and that it should of already been done with no arguments.
He will speak to the gynae clinical lead at the surgery and arrange more blood tests as I haven't had all that I should .
Some progress

[lildottie]

that's great news not. things don't seem to move all that quickly at first but they will start moving now! good luck.

[naty1]

Tbh i would probably have given the metformin time to work. It may help the irregular cycles. I certainly got the ewcm on it.
I would prioritise the SA as it may not be your issue .
Weight loss, possibly and low GI diet.
If you have a DC you probably ovulate sometimes.
Finding i had pcos was only the start for me, i also ended up with hypothyroidism and had a 10 day luteal phase.

[notamonkeysuncle]

naty I've pushed to be referred because the nice guidelines state I shouldn't of been given metformin without a referral, the GP also hasn't done all the blood tests they should of. I've had one on day 21 where they only tested progesterone levels.
I also have many questions which the GP can't answer.

[naty1]

Im sorry but you asked for opinions - not just everyone to agree with you.
I dont think they have to apply NICE its guidelines.
You already know you have pcos. The day 3 tests would likely just confirm this.
You also know that the day 21 test is likely to show no ovulation if you test day say 21 and have a 50 day cycle it would be before ovulation.
The only reason to repeat would be if you need a referral to a fertility clinic. Or your cycle has changed.
I am surprised gp would prescribe metformin as anything like that was done at my fertility clinic.
No harm in seeing a specialist.
But you dont want to PO the gps especially if you want to go there during pg and with the baby.
Ive seen some awful gps - was told ovulated then when i questioned they looked again and i hadnt.
They know nothing about fertility.
But they may need to do your referral to a fertility clinic if you need one.
Or can the gynae prescribe clomid etc?
How long have you been ttc?

[lildottie]

naty that was a bit harsh, she was just explaining why she had pushed for the referral when you said she should have given the metformin a chance.

to be honest not i'd PO the GP if it got me to where I needed to be, you can always change GP for your care during pregnancy! And anyway, they are supposed to be professionals, do no harm and all that, so it shouldn't make a blind bit of difference.

[naty1]

You can change gp but i suspect as your notes follow you...

But i wouldnt have PO the gp i would have just booked in to see another and explained the situation again. Chances are they would as they did refer anyway. Just a different perhaps manipulative way of doing it.
I agree gps shouldnt get away with lots, but it doesnt sound like they were being that unreasonable to me.

Met works quite quickly so you would know in a month or 2 anyway if its sorted cycles.

I would pay privately to see a gynae if that who i wanted to see, i suspect it would be less than £200 and not wait 9mths but then im probably older and having been dealing with infertility stuff for over 5yrs seeing how slowly nhs stuff moves.

Anyhow it doesnt matter as its done now and op has the referral she wanted.

[notamonkeysuncle]

As my update said I did speak to another GP who agreed the referral.
People with PCOS should be referred as they ask for help not just given a prescription. That became clear very quickly on this thread.