Active discussions

Please or to access all these features

Talk
AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

If I make a complaint about my GP refusing to prescribe medication

283 replies

Sconesandgravy · 09/04/2024 18:32

My neurologist asked the GP to prescribe a medication to help with a medical condition. The medication is one can cause birth defects. I spoke to the pharmacist this morning who called to say she was putting the request through to the GP. The pharmacist messaged that afternoon to say the GP has refused to prescribe unless I go on hormonal contraception or the copper coil. He has claimed that guidelines say he can't prescribe if I refuse the above types of contraception.

I want to complain about this for several reasons:

  • My husband is completely infertile. He had multiple samples of testicular tissue biopsied and it was confirmed he has a condition that means his sperm count will always be 0. The only way I'm getting pregnant is with a sperm donor. I obviously can't do this by accident. The pharmacist made the GP aware of this because she called me this morning and said contraception is recommended, so I said I'm not on contraception and disclosed about my husband.
  • I checked the guidelines myself. NICE guidelines state the need for effective contraception must be expressed. The BNF says effective contraception must be advised. On gov.uk there is a 2022 safety review of the medication that states health care practitioners "should fully inform the patients of the risks and advise them of the need to use highly effective contraception". Nowhere specifies what contraception should be used, and none of the above bodies specify that medication should not be prescribed if long term contraception is refused. The only thing I can find is that alternative medications can be offered if the medication is long term and the patient doesn't want to use any form of contraception.
  • Condoms and abstinence are also effective forms of contraception. If I were a man these would be recommended as they're the only available form of effective male contraception. It seems discriminatory to suddenly decide they're not considered effective contraception just because I have a vagina.
  • I'm an adult with full capacity. I have the right to make an informed decision about what I put into my body.

In all honesty it just feels a bit like the GP has refused my prescription and intentionally given me misinformation about the guidelines to try and coerce me into going onto a contraceptive that he deems the most effective, rather than allowing me to make an informed decision based on my own personal circumstances. I know this is dramatic and I won't put that in my complaint but I just needed to get that thought out of my system

AIBU if I complain?

OP posts:
Hopebridge · 10/04/2024 09:13

I am also on topirimate and I don't take contraception.

Hopebridge · 10/04/2024 09:12

I am on a similar medication. I would just see a different GP in the practice and explain. I'm sure it will be fine and they will prescribe. Some GPs are just difficult. I have to sign to refuse pregnancy tests for some treatments in hospital even though my DH has had a vasectomy and 0 sperm count. I wouldn't complain yet.

gamerchick · 10/04/2024 08:54

Wouldn't it just be simpler to agree to the pill and just not take it?

I've found they will always go with the "we can't assume your husband is the father" mindset. It sucks but it is what it is.

marmaladeandpeanutbutter · 10/04/2024 08:47

Make the appointment to see the Gp in 3 weeks.

CornishPorsche · 10/04/2024 08:27

Wildro · 10/04/2024 07:05

How can you lie about your contraceptive plans? If highly effective contraception = coil or implant? Not sure a GP is going to believe that

Show quote history

Well he did, because I was on it for a couple of years.

Topiramate can actually affect the efficacy of hormonal contraception like the Pill, so other methods are preferred. My GP must have taken the husband's infertility into account.

prescribingmum · 10/04/2024 08:24

BeautyGoesToBenidorm · 10/04/2024 07:13

I was prescribed sodium valproate for bipolar disorder, when I was 17. There was no conversation about contraception, or the risk of birth defects.

A few years later, I saw a psychiatrist who was absolutely horrified that I'd been prescribed it. I knew none of the dangers and I'm truly grateful to that woman!

It is something that we (the professionals) have learnt more and more about over the past 20 years. When I qualified just under 20 years back, there were no restrictions on valproate in pregnancy. It was considered to be appropriate (alongside high dose folic acid) if the risk of seizures/relapse in mental health was greater than risk of medication exposure. Studying outcomes of women taking it showed us that the risk of harm to the foetus are too great and now pregnancy is an absolute contraindication (like thalidomide and isotretinoin). As Pp have mentioned, guidelines have been tightened even more this year to include men fathering babies when on treatment

BeautyGoesToBenidorm · 10/04/2024 07:13

I was prescribed sodium valproate for bipolar disorder, when I was 17. There was no conversation about contraception, or the risk of birth defects.

A few years later, I saw a psychiatrist who was absolutely horrified that I'd been prescribed it. I knew none of the dangers and I'm truly grateful to that woman!

Mere1 · 10/04/2024 07:05

HE could be female.

Wildro · 10/04/2024 07:05

CornishPorsche · 09/04/2024 21:24

Hi OP, I was on topiramate, prescribed for me by the GP for a long time before I ever got to see a neurologist. TBH it did fuck all except give me appalling side effects, but I am aware it works for other people.

My DH is also infertile (bugger all sperm in the samples, absolutely nothing capable of swimming - what was in the sample was either dead or so mutated it couldn't actually move in any direction) due to being a premature baby and subsequent issues with undescended testes so everything was literally cooked.

If I recall correctly, I also lied and said we'd use condoms and a diaphragm with spermicide :-) Then used nothing as usual.

I do actually have the Mirena coil now to deal with perimenopausal symptoms, and to try to see if it helps with my chronic migraine (nope, but I'll try anything!).

So my advice is lie to the GP. The BNF guidance on women of childbearing age and topiramate states "Manufacturer advises perform pregnancy test before the initiation of treatment—a highly effective contraceptive method is advised in women of child-bearing potential; patients should be fully informed of the risks related to the use of topiramate during pregnancy."

https://bnf.nice.org.uk/drugs/topiramate/

I'd go back to the surgery with that link, the quote and your description of your (imaginary) contraceptive plans.

Whatever happens, please please check the list of side effects and be aware of them - I was an absolute zombie after 2yrs, it nearly cost me my job and my marriage because I was such a mess. The GP was worried I had blood cancer or something but we finally worked it out..... I'm not allowed it again!

For hemiplegic attacks, it was actually Botox (via neurology) that got on top o those for me. I'm down to a couple a year from two a week....

How can you lie about your contraceptive plans? If highly effective contraception = coil or implant? Not sure a GP is going to believe that

Wildro · 10/04/2024 07:00

twitternotx · 10/04/2024 06:03

Actually the funding for coils and implants is so miserly that many surgeries lose money on each fitting. We continue to do it for the benefit of our patients.

Show quote history

Yes this is the same at my surgery - stopped doing them a while ago as couldn’t finaciakly continue to offer the service

sashh · 10/04/2024 06:08

Sconesandgravy · 09/04/2024 19:09

In response to everyone saying enter into dialogue with the GP - I would if I could but I have no way to.
The practice only sends one way messages via text with no way to reply, I asked the receptionist if I could book an appointment or get a message to him, he isn't available for 3 weeks.

GP also stated on my records that I've had a conversation with the pharmacist about my reasons to decline contraception and he's decided it's inappropriate to prescribe until I agree to a contraceptive. So I'm really not sure what else I can do other than complain.

Take the appointment in three weeks.

In the meantime write a letter to your GP explaining everything you have said here so there is a paper record.

In the letter say you accept the risk.

twitternotx · 10/04/2024 06:04

SpidersAreShitheads · 10/04/2024 02:56

Hey OP - firstly, my sympathies. Hemiplegic migraines are fucking vile. The weird hemi paralysis that goes along with the migraine is horrible.

I was diagnosed about 15 years ago following neurological investigations including an MRI.

I’m asthmatic so my neuro didn’t want to try beta blockers. Have they tried those with you? I was actually prescribed a glaucoma drug that’s used off label for hemiplegic migraine. I took that for years and it really helped.

I’m now 48 and for the last 10 years or so my hemiplegic attacks have calmed down hugely. I don’t take any meds now - just pain relief when an attack strikes.

The attacks were horrific in my late 20s and through to my late 30s. They're incredibly disabling so I really feel for you.

I’ve had a complete brain blank and can’t remember the medication I used to take! 🤦🏻‍♀️ I was just thinking you could ask your neurologist about it as an alternative. My neuro was excellent, really on the ball- I don’t think this medication was widely used but it really worked. And quickly.

Secondly, long story but my partner collapsed two years ago with a neuro condition which causes severe migraines and dizziness. His neuro prescribed Topiramate for him about 6 months ago. As per PP, they do make him very zombified so it’s a bit of a balancing act.

Interestingly though, he wasn’t asked about his fertility, nor about contraception. The neuro didn’t know my age so I could easily have still been of childbearing age as DP is only 40.

I appreciate there would have been no way to foist contraception on a bloke, but if the risks are so high surely he should have been warned about getting me pregnant?! Nothing was said. Topiramate prescribed without a murmur.

Personally, I would challenge it via the practice manager. The GP is citing guidelines that don’t exist, leaving you in pain as a result. The neuro’s opinion normally takes precedence in these situations and you shouldn’t have to take hormonal medication - which have their own risks - that you don’t need just because the GP can’t employ some critical thinking.

Yes but if it doesn't damage sperm then that would have been irrelevant.

twitternotx · 10/04/2024 06:03

Saytheyhear · 10/04/2024 00:55

How much does the surgery make from patients who have the copper coil fitted by them?

They receive no money or government funding from abstinence or condoms.

Follow the money on this dictatorship of contraception.

Actually the funding for coils and implants is so miserly that many surgeries lose money on each fitting. We continue to do it for the benefit of our patients.

HoppingPavlova · 10/04/2024 03:29

A positive story. DD is on topiramate and has definitely assisted migraine aspect considerably and had no side effects apart from some paresthesia which was easily solved by changing timing of taking tablets, so like every medicine, side effects are not universal for everyone.

BrokenBonesStixStones · 10/04/2024 03:17

I feel your frustration OP. I’m on a medication with similar side effects and the amount of grief I got from hospital, consultant, GP & nurses(currently single, for the foreseeable) about contraception. It felt really invasive. I don’t want to take contraception if I don’t need it. Luckily they gave it to me in the end but I almost agreed to take the script and just not take it just to make it stop. Which would be a total waste of funds

SpidersAreShitheads · 10/04/2024 02:56

Hey OP - firstly, my sympathies. Hemiplegic migraines are fucking vile. The weird hemi paralysis that goes along with the migraine is horrible.

I was diagnosed about 15 years ago following neurological investigations including an MRI.

I’m asthmatic so my neuro didn’t want to try beta blockers. Have they tried those with you? I was actually prescribed a glaucoma drug that’s used off label for hemiplegic migraine. I took that for years and it really helped.

I’m now 48 and for the last 10 years or so my hemiplegic attacks have calmed down hugely. I don’t take any meds now - just pain relief when an attack strikes.

The attacks were horrific in my late 20s and through to my late 30s. They're incredibly disabling so I really feel for you.

I’ve had a complete brain blank and can’t remember the medication I used to take! 🤦🏻‍♀️ I was just thinking you could ask your neurologist about it as an alternative. My neuro was excellent, really on the ball- I don’t think this medication was widely used but it really worked. And quickly.

Secondly, long story but my partner collapsed two years ago with a neuro condition which causes severe migraines and dizziness. His neuro prescribed Topiramate for him about 6 months ago. As per PP, they do make him very zombified so it’s a bit of a balancing act.

Interestingly though, he wasn’t asked about his fertility, nor about contraception. The neuro didn’t know my age so I could easily have still been of childbearing age as DP is only 40.

I appreciate there would have been no way to foist contraception on a bloke, but if the risks are so high surely he should have been warned about getting me pregnant?! Nothing was said. Topiramate prescribed without a murmur.

Personally, I would challenge it via the practice manager. The GP is citing guidelines that don’t exist, leaving you in pain as a result. The neuro’s opinion normally takes precedence in these situations and you shouldn’t have to take hormonal medication - which have their own risks - that you don’t need just because the GP can’t employ some critical thinking.

therealcookiemonster · 10/04/2024 01:23

Saytheyhear · 10/04/2024 00:55

How much does the surgery make from patients who have the copper coil fitted by them?

They receive no money or government funding from abstinence or condoms.

Follow the money on this dictatorship of contraception.

Trust me no one has the time to do extra procedures that are not needed

half the time GPs struggle to get the essential things done

there is no conspiracy.

violetlozenge · 10/04/2024 01:18

Sconesandgravy · 09/04/2024 20:03

He's willing to prescribe both at the same time without seeing me. The message I received said if I want the pill then contact the clinical pharmacist who will put through both prescriptions, or make an appointment to see the nurse and once the coil is in place my script will be issued. I just don't want to waste resources if I'm honest.

Show quote history

You don't want to waste resources by taking the obvious go-around, but you do want to waste resources by making a complaint about the GP who is trying to follow guidelines?

Saytheyhear · 10/04/2024 00:55

How much does the surgery make from patients who have the copper coil fitted by them?

They receive no money or government funding from abstinence or condoms.

Follow the money on this dictatorship of contraception.

LiterallyOnFire · 10/04/2024 00:00

Balloonhearts · 09/04/2024 19:22

I did a quick Google and what immediately came up was high risk of neural tube defects. I can see why he doesn't want to risk prescribing it without you being on contraception and he is within his rights to do so.

The husband infertility thing is a red herring, marriages do end, people do have affairs, he can't take chances and make a judgement call on the likelihood of this happening, he doesn't know you.

Neural tube defects can be horrific. Anything from a cleft lip to spina bifida or even holoprosencephaly. Google an image of a child with Cyclopia and I think you'll understand. If you are currently pregnant or don't have a strong constitution I suggest you do NOT Google cyclopia. Its not a sight you'll forget in a hurry.

Red herring my arse. It's her current situation. She can manage her own fertility whether her marriage ends or not. But for now, contraception isn't an issue because the man she sleeps with is incontrovertibly infertile. Which is enough reason not to make contraception a condition of prescribing the neuro medication she needs.

Why are some women happy to be patronised because they own a womb?

JayJayEl · 09/04/2024 23:55

Notthatcatagain · 09/04/2024 18:53

I cared for a lady who became pregnant while taking drugs with a very high risk of birth defects, sadly her pregnancy was terminated. The doctor who had prescribed them was beside himself over it. From then on he was incredibly strict about all his patients being on contraception before he would prescribe, no exceptions, ever.

Even for lesbians?!

Original poster
Sconesandgravy · 09/04/2024 23:43

Snackarooney · 09/04/2024 23:26

I had a similar issue with meds prescribed by neurologist & gp.
Do any off tour apps let's have your neurologist direct / secretary's direct number or email? I called and she invited ne back in to squeeze me in between apps asked me exactly what had happened then spoke into something (don't know what they're called I'm tired) for her secretary to type up and send priority to my gp, she wiped the floor with them & told ne to complain to qcc. Never had a problem since, gp was so apologetic I almost felt guilty.
Definitely complain. Good luck x

They do, but the neurologists secretary isn't particularly helpful either. I have to email or call multiple times to get the bare minimum. When my symptoms worsened I had to threaten PALS after sending multiple videos of the issue before anyone responded to me. She wouldn't help with a prescription issue as she's very "what he says goes" x

OP posts:
Original poster
Sconesandgravy · 09/04/2024 23:37

twitternotx · 09/04/2024 22:51

I would just caution you that you're likely to wait a year for another opinion on the NHS......topiramate perfectly reasonable option for migraine

Edited

I ideally need to transfer my care anyway as I'm moving 180 miles and the neurologist still has me on his books for follow ups (although he hasn't clarified how often). Part of my reluctance to take the medication is because of the issues I've had with the neurologist.

The other part is because I've had a lot of medical issues over the past year. When I was admitted to hospital after becoming unwell last week, the registrar who examined me said she thinks all my issues including the migraines are linked and referred me for a variety of tests.

I don't know whether it's worth delaying medication until all these tests are done or not, but I can't get advice from neurology as they take weeks to respond, and the GPs is so full I can't get an appointment until a week after the first lot of tests. When I asked the department that does the tests they said ask my GP so I'm none the wiser in that sense. I won't lie I do feel a tad frustrated 😔

OP posts:
Snackarooney · 09/04/2024 23:27

sorryI'm half asleep

*do any of your appointment letters

Snackarooney · 09/04/2024 23:26

I had a similar issue with meds prescribed by neurologist & gp.
Do any off tour apps let's have your neurologist direct / secretary's direct number or email? I called and she invited ne back in to squeeze me in between apps asked me exactly what had happened then spoke into something (don't know what they're called I'm tired) for her secretary to type up and send priority to my gp, she wiped the floor with them & told ne to complain to qcc. Never had a problem since, gp was so apologetic I almost felt guilty.
Definitely complain. Good luck x