to find trying to deal with my GP surgery a complete nightmare?

[greygeese]

Nearly 6 months ago went to GP for advice re contraception and was encouraged to go for the depo injection. First one was ok, since the 2nd I have bled constantly, anywhere from slight spotting to a full on period. I've had one day's grace in the last 3 months. Went to GP after the first couple of weeks who prescribed tranexamic acid (didn't stop it) and suggested I should wait for 3rd injection which should resolve problem, or I might need to go on the pill as well. Last few weeks it's been getting worse so last week I went back and saw another GP at same practice who has put me on Norethisterone (finally stopped bleeding, hurray!) and said no, that's nonsense you can't be on pill and injection at same time, you have to choose, but that my best option would be the coil, and that to have that I have to a) come back for a swab in the next 7-10 days once the bleeding had stopped and b) that I have to go to another surgery 7 miles away for the coil to be fitted…

Wasn't impressed with this, but in talking it through with my partner he is of the view that I don't want another 3 months like the last 3, and it's better to get the coil now than risk a repeat, and having to wait 3 more months post injection to try another method.

So, I have an appt with GP booked for Sat, I originally booked this 3 weeks ago (before I managed to get an emergency appt next week) so rang up today - now the bleeding's stopped - to check it was ok to use that for the swab.

Apparently not. GP's can't do swabs, only the nurse, and her next appt is 16 days time. By which time I will almost certainly have started bleeding again, and my injection will have run out (currently have an appt for injection 3 in 2 weeks time, which is nearly 13 weeks since my last one).

GP never mentioned I needed to see a nurse not a dr! and was well aware when my next injection was due, but didn't seem to see any problem with getting the coil before then, although clearly it's going to be impossible. Am a bit at a loss now, and feel like all I can do is have the injection, which I suspect will just put me back to Square one :(

There are no other local surgeries with spaces (otherwise I'd take my chances) and the family planning/contraceptive advice clinics in our area are only for under 25s (I found this out prior to seeing my GP back in May when I spent weeks waiting for an appt…)_

Am still furious about it though, it really should not be that difficult to access contraception. As for being asked to wait 8 weeks, utter lunacy.

Apparently one of the other GPs deals with complaints. But you have to write in as they don't have email!

This is not some surgery in the arse end of nowhere btw, but an affluent London borough.

I am waiting on my appointment to get the coil fitted and had to have swabs taken before I get the coil my go gave me swabs I take myself.
I went home took my own swabs then returned them to the gp practice.
Just wondering if this would be an option for you? Would be no harm in asking can you do the swabs yourself.

There is no way they'd let me do my own swabs, everything has to be done by one bloody nurse who is clearly run off her feet doing all the jobs lazy GPs should be doing!

There is no reason why anyone in a country with a supposedly brilliant health service should have to wait 3 weeks to see a nurse. Was talking to friend today who has a similar issue with bleeding to me (although slightly different as she is not on any contraception and the medical view is it's her age...41) anyway her GP has been nagging her to go for a smear for 18 months. She gets about 2-3 days every couple of months when she stops bleeding. But can't predict when. Hence she can never get in for a smear as her nurse never has less than a 3 week wait.

I have no idea what we are expected to do.

Although my main concern now is that I'm being refused any form of contraception for 8 weeks from 'expiry' of my injection which is a joke. I'd like any medical professional to defend that stance.

I'm very happy with my implant, although actually getting it put in isn't pleasant. They last 3 years. Is this an option for you?

grey that is absolutely appalling. I had the same problem re bleeding and smear as your friend I seem to be on a 14 day cycle. Luckily my FP clinic managed to do a smear when i was coming to the end of a period and still lightly bleeding. And i got a letter back from them saying that it was normal.

8 weeks without contraception is ridiculous. I know there are condoms but they can split. Is your GP providing abortion on demand!!!

Im 41 too Same age as your friend.

Actually re reading that your friend has it worse than i do and the clinic urged me to get it checked out

If it were me I would go on to condoms for a couple of months to get my cycle back to normal then go for the coil - with such a response to the depo I would want a break so that any symptoms from the coil could be monitored - otherwise I would be wondering whether symptoms from the coil were in fact residual effects of the depo - I was on the depo for over a year but it really didn't agree with me - not bleeding but it turns out I have pcos so think the hormonal imbalance on top of that from pcos was too much for me!

Ps have you looked up your family planning clinic - often they have walk in surgeries

So gp didnt even discuss condoms, femidoms, or the cap with you? Thats really bad.

Ps hadn't read about the drs 2 mth advice - I genuinely think that if your hormones have been out of whack so much that you bled for a majority of 3mths then it really would do your system good to get it back in cycle- depo v powerful (can't think of better wording) IMO to then bound in to another hormonal treatment without giving your body a rest would not be best - I really did take a couple of cycles to feel normal again after it. With the pill many women try several types until they find one that works best for them - and watching the symptoms helps the dr know whether you should try a different one - but if you had a reaction then there could be confusion as to whether the depo or the new pill were to blame.

When I asked about family planning back in May when this saga began, I was told it was only for under 25s. So that's not an option.

I'm in my 40s. I've never been on any hormonal contraception. Never taken the pill, or anything else until 6 months ago, and I've now had enough hassle to last me a lifetime.

If I can't change GP I will have to go back to condoms, which we don't like/ don't really work for us. Meh.

The point is though the first GP I saw said I could have the pill as well as the implant to control the bleeding.

I'd be happy to try that.

The GP I saw the other week disagreed as did the idiot I saw today.

I want a reliable form of contraception where I am not bleeding.

I've been expressly refused pill and injection. I've been refused pill alone for at least 8 weeks. And who knows whether on a whim they'll refuse it then for some other reason.

Practically I cant have the coil because of the logistics of waiting for swabs, travelling miles to have it fitted. And I'll probably bleed with that anyway if what I've read is correct.

Today's GP was very clear he would not provide any form of contraception today, nor for at least 8 weeks.

I am usually an ardent supporter of the NHS. I left today knowing without a doubt if I'd been paying, I'd have received a much superior service.

Have you googled the nice guidelines or the bodies that govern this area of medicine - they often set out what the escalation of treatments should be and what they view as best practice - we don't have your medical notes or know whether the first dr you saw was right or the second and what they read in your notes or understood of the treatments thoroughly enough - should you have seen someone when you were bleeding for so long? Is that what the gp is concerned about as tbh the 2 mth wait sounds familiar when coming off depo -have you reviewed the literature on depo? Is there advice on that - with the issues people have had on depo I'd be surprised if there wasn't loads of stuff out there and possibly people who have had the same response as you.

I understand you don't want to use non hormonal contraception but if it is genuinely in the interest of your health then maybe suck it up for a couple of months - checking out the reports online (taking note of more reliable sources such as recognised health bodies) might help you work out where the second gp was coming from or give you an informed argument for a second appointment.

This was the 3rd GP I've seen, and my 4th appt in total.

The second suggested I have the coil fitted immediately. No suggestion of waiting 8 or more weeks. No concern over bleeding. She said coil would stop it (that's possible but not certain).

Bleeding is common with injection. Unfortunately 1st GP didn't tell me that til after it started happening.

There is plenty of reference to trying women on the pill in combination with injection. On this thread it has also been suggested. That option was flat out refused today.

I wasn't dead set on switching to the pill. I was given Hobsons choice. Actually less than that because I was told I couldn't have any form of contraception.

Today's GP hadn't read my notes. He had no actual concern over my bleeding. He didn't ask me a single question about it, or about anything. He's not referred me for blood tests, scans or investigations. He's sent me away with nothing, to wait. I'm not concerned I know the bleeding at my age isn't unusual. It's also not unusual with the injection.

However what concerns me is I was refused treatment id previously been offered, nor any alternative, and that this bastard made me feel like I had a nerve asking for contraception. Probably because I'm not married .

greygeese your last post has made me wonder whether his possible religious affiliations if he has any are affecting his judgement. I was wondering about it already but your last post has made me post this.

no wonder you're furious - I would write up a timeline with both your symptoms and contact with doctors and their advice etc, gather some of your research to back up your case and ask for a 4th opinion.

You lasted till your 40s using non hormonal contraception I'm sure another 8 weeks won't do u any harm in in agreement about the 2 cycle break... Most women go through all this before getting a contraception that suits them it's not a quick fix solution most of the time... Im 23 and still have all this going on add on top of that endometriosis and I've abstained for a lot longer than 8 weeks inbetween contraception... I agree the waiting times are unreasonable but youll b hard pushed unless u pay private to get any doctors that don't have lengthy waits but I do agree with what the doctor is saying. Im under a gynae surgeon and consultant and have been given the same advice on many occasions about am having a couple of normal monthly cycles

Is there a reason why you shouldn't be on the pill after a certain age?

I've been on microgynon since I was 17. I stopped to have each of my children in my early 30s and am now 37 and still taking it.

It has never been suggested to me by my GP that there is any reason to stop but it has crossed my mind what I should do long term now that our family is complete.

Darkest, I was trying not to jump to that conclusion. But the fact he didn't ask anything about my bleeding, stonewalled my request for contraception and didn't offer any alternative other than come back in 8 plus weeks and see another GP makes me think there may have been more to it.

Fwiw I've 'managed' without hormonal contraception previously because I was not sexually active until well into my 20s. I was then either ttc, pregnant, or having sex so infrequently that condoms were a suitable alternative. I was then in a relationship with a man who'd had a vasectomy. I was then single for many years. I am not now single, and wanted a more reliable alternative than condoms which don't work well for us. We have already abstained for large parts of the last 3 months which is almost half the time we've been together. In such a new relationship it simply isn't sustainable and has made us both unhappy.

It is the fact this 8 week wait has never been mentioned before yesterday which concerns me. It feels like an excuse to fob me off.

Like I said, if this GP was concerned by the bleeding, why didn't he ask about it- how much, how often? Did I have any pain or any other symptoms? He asked nothing. And I can read my notes from the computer screen and the last one said no more than 'continued bleeding. Norethisterone prescribed. Mirena recommended' or words to that effect and of similar brevity.

I have written my complaint letter. Not impressed with having to send it by post.

If you are a non smoker and BMI under 35 there is no reason you cannot be on a combined pill. However there is also no reason why you can't be on injection and also Norethisterone long term.
Bleeding on the injection should have settled by the 3rd injection even if that means getting it at 8 weeks initially. If it has not settled it is not for you. www.sandyford.org/media/37384/depo%20provera%20ceg%20march%202014.pdf
As regarding the swab before the coil is fitted-that is a very old fashioned idea which was stopped quite a few years ago. The GP you saw obviously was out his depth or completely ignorant about contraception.
I am a practice nurse and have a very long wait for appointments (although the GP's will go occasional swabs and smears) l think the problem is my wages comes out their budget so another nurse would mean less profit for them .

Oh blimey that does sound bad. Please send your letter of complaint via registered post.

And when you get to a dr who listens may i recommend the patch? Periods are light, like clockwork, and ive had no other side effects. GP may not be keen on it because it costs more and they are supposed to push long term hormonal contraceptions.

Inlect, I am a non smoker (never smoked, both my granddad and my mum died from smoking related cancers, hence I have never even tried it) not sure on my BMI, I know I am in the overweight category but can't remember the number.

I've not yet had my 3rd injection, I have an appt for that in 10 days. It was about 8 weeks when I saw the 2nd GP but she was pushing for me to have the coil and didn't suggest an early injection. The norethisterone works brilliantly for me, stopped bleeding in a couple of days, no side effects im aware of. I'd be happy to take it alongside the injection if that was an option.

Red, interestingly when I saw the first GP I mentioned the patch as it seemed to me to be (as a novice to the world of hormonal contraception) less 'invasive' than other options...she was very dismissive, said it was unreliable and falls off a lot, so I shouldn't have it!

Erm, its more effective than the pill because it doesnt rely on your digestive system to absorb it. Ive had one come a bit loose but not fall off in 7 years. There is less room for user failure because you only need to change it once a week rather than everyday. GP is talking shit.