To feel like I'm being railroaded into an IUD?

[NotQuiteJustYet]

I'll begin by apologising if I've put this in wrong place - I couldn't find a contraception section.

I've been prescribed a medication by my endocrinology consultant to regulate my hormone levels which my GP was meant to give me the prescription for. The letter from the hospital states this can only be done once I'm on reliable contraception as this medication has a known effect of making women more fertile - fair enough, I'm fine with the need for sensible contraception.

I'm also on a medication which I absolutely cannot risk getting pregnant on as it has a known risk of birth defects. DH and I are well informed about this and happy to wait to have children anyways.

GP today has essentially refused to print prescriptions for this medication until I've been fitted with an IUD because he feels hormonal contraception would undo the work of the meds prescribed by the consultant.

DH and I have been using condoms for 5 years now with no mishaps but I understand why this is no longer sufficient. Am I going to have to suck it up and have the copper coil fitted?

Does anyone have any fitting stories where they didn't end up in agony?

Hs attitude over this has absolutely shocked me because he's usually amazing with everything else. I discussed my concerns about the procedure and he just said very few women actually feel any discomfort during it which seems just beyond belief to me. Honestly, I'm scared shitless about it.

I can see where he's coming from though, he's trying to minimise all risk to me and a potential life that could be unwillingly created should a condom break as the morning after pill has reduced effectivity as a side effect of the migraine medication, as does oral contraceptives.

I've booked an appointment to discuss an IUD with a local clinic not attached to the surgery to get their view on this.

Haha SoggyBottoms I'm going to book another appointment, tell him I've divorced DH and joined and order with the nicest habit I could find and married god instead.

I think diddl's question is key. There are much lower hormone levels in either a mirena or an implant than in oral contraceptives, and the endocrinologist may feel that these are options for you too - does the letter specify copper coil only, or might your GP might be overintepreting the endo's advice?

I'd take that migraine meds/oral contraceptive seriously OP.

I took (what I think) you're speaking of here only for a few days - It drove me batty - and then switched to something else.

But that few days was enough to override a pill which had been working perfectly for ten years prior and DD is now 6!

No-one warned me about that side effect - I had to look it up on my own, afterwards.

FWIW, and you may know this already, combined oral contraceptive pills are contraindicated for migraine sufferers, so there's that, as well.

If your GP feels that a particular combination of medication would be unsafe or ineffective he's not obliged to provide it. If something goes wrong he will be held accountable for his prescribing, even if you requested it or another doctor advised it. It sounds lie you think he's usually a sound doctor and he's likely to hVe genuine concerns. You might find another GP has a different opinion and is willing to prescribe, or you may want to get an opinion com a family planning clinic or gynaecologist about your circumstances.

I once worked in social gynaecology (termination) clinic - many woman were using condoms when pregnant.

The gynaecologist once commented - yup that's what i expected when hearing the age gap in someone's pregnancies when using condoms. She's expect you to be pregnant once every two years with regular sex and effective condom use!

I was blown away. But tbh she was right in everything she said.

Why not ring the consultant and ask his opinion too? But I'm pretty sure he'll feel the need for a LARC (long acting reversible contraception) too. If he doesn't then he needs to prescribe the medication. The GP is right not to prescribe - I wouldn't want to be responsible when you become pregnant, decide you want the baby because no one can tell you how deformed the foetus is and then there is a daily fail story "drug x caused my baby to have no skull/legs/heart" and suddenly people don't want the drug and their health suffers.
Harsh but very true.

'I discussed my concerns about the procedure and he just said very few women actually feel any discomfort during it which seems just beyond belief to me'

WTAF? How would he know, anyway, he's got a fucking wanger?

Copper coil was horrendous for me - was led to believe it was the only option for me - caused me clinical shock every month (passing out at work, days in agony in bed), got rid & felt a million times better.
But everyone's different.
Get another GP's advice

I am on my 3rd copper coil (2 pre DS, 1 post). I didn't have a cervical anaesthetic, just took 2 ibuprofen an hour beforehand. My periods were heavier for a few months, then went back to normal. It certain't wasn't as nice as eating a bar of chocolate, but it wasn't too bad at all. I certainly wouldn't be on to my 3rd one if it were that terrible! For some like me, it's trouble free.

Your body, your choice. I would second getting a second opinion.

Is it topiramate OP? That's the medication I was referring to above, and I was also on it for migraines. I was/am not known infertile, I've never been pregnant but there's no reason to believe I couldn't become pregnant, yet my GP was ok to prescribe while I was using barrier methods. So this is not a blanket policy - could you ask for another discussion or a second opinion?

The endo specifically suggests an IUD at the end of his letter but not a copper coil however states I must be placed onto reliable contraception before being given the new meds, stupidly I just kind of assumed I'd get the depo and put up with the crazy.

GP is pushing for copper coil because of the history of hormone imbalance and has sent me away to book an appointment with the clinic to have an IUD fitted, and told me to come back once it's done for the other medication.

Yes Naoko it's topiramate. He was fine with me being on this using a barrier method prior to the introduction of metformin, but because metformin can boost fertility dramatically he doesn't want to risk pregnancies, especially with the drug interaction between the two making the metformin more potent.

'GP is pushing for copper coil because of the history of hormone imbalance and has sent me away to book an appointment with the clinic to have an IUD fitted, and told me to come back once it's done for the other medication.'

Not a decision for him to make. I'd see another GP.

I think you're all right. I need a second opinion here. I'm not at all comfortable with having something whacked in my womb to keep someone else happy.

I'm going to keep my appointment with the clinic and discuss contraception with them as that's their specialty then go back with the letter from Endo again and grab an appointment with whoever I can get usually a locum who won't have checked what's gone on anyways, the only reason I saw my usual GP today was for an ongoing issue he's been an absolute angel for.

To answer your last question first I had a copper Coil and whilst it wasn't my favourite way to spend an afternoon it wasn't agony. I took parcetomol before as advised. Periods were only grim for the first couple of times. Since then they have lighter and shorter.

I understood that condoms are lower protection rate than condoms. So the gp just wants reduce the chances as much as possible of you having a deformed baby.

Yeah it's not fun, but yabu, the gp is trying to take appropriate actions for you.

I can't believe your GP is railroading you into an IUD and I say that as someone who chose to have the Nova-T copper coil fitted this Monday just gone.

I had mine fitted by my OBGYN who is excellent, and it was still painful. Yes the pain only lasted a few seconds and the residual cramps have passed by this morning, but I have been popping 800mg ibuprofen since then. I found it similar to a very strong labor pain and/or my sweep (which to me was the most painful part of both my labors).

I didn't want hormones after 6 years off the pill so this was my only option as I'm getting bored of withdrawal, neither of us like condoms and I don't want DH to get the snip.

But to withhold your prescription until they are satisfied that you're on the contraception that they deem worthy is fucking ridiculous. Disgustingly sexist behavior, what they don't trust you to manage your own contraception carefully enough? Would they ask a man the same question?

Grrr, that's really pissed me off! It's not a comfortable procedure that they should just be trying to force people into, it's a choice every woman should make individually.

I'm on my second copper coil, no DC
Periods slightly longer, no other changes
I had anaesthetic gel (instilligel) before which is just applied (no injection) and took some painkillers. Done at family planning and all fine

I don't think your're being railroaded into anything. I think you're being told that you can't have certain medications without having very reliable contraception. Condoms are not reliable enough.

They are giving you their professional opinion as to what would be best, you don't have to take it. I think you're being over dramatic about it all.

I think your endocrinologist is being ridiculous. Metformin doesn't make you any more fertile than a person with naturally regular periods. I.e. It can help bring you to normal fertility if you have PCOS or similar but you still wouldn't be more than normally fertile.
I think he's overstepping his role tbh. He hasn't prescribed the medicine which makes getting pregnant dangerous and the person who did prescribe it was obviously happy with your method of contraception.

Can you get a second medical opinion?

I think this is outrageously patronising and I bet it wouldn't happen to a man

Of course it wouldn't, since a man can't get pregnant. Idiotic comment

Also idiotic are the "no-one can force you" yada yada...of course they can't, no-one wants to force you to do anything. They are suggesting. It's their JOB.

You shouldn't feel pressured into anything, but as a responsible prescriber neither should your GP. Keep in mind he's only doing his job to the best of his ability.

That said, a discussion with the experts in contraception sounds sensible.

I would keep in mind that as you've said the medication you're taking reduces the effectiveness of the MAP, you are risking leaving yourself with no choice but a coil to prevent an unwanted pregnancy should condoms fail you (that you're aware of). I think you can have one fitted up to five days after unprotected sex or a broken condom. I would be concerned about getting that sorted out in that time frame, but I live in a shit area.

AndTake I'm not saying I'm not prepared to take/do anything else, I walked in there perfectly willing to drop my pants and have the depo done then and there, GP refused on the grounds that the high level of hormones being injected would counteract the work of the metformin. I'm also absolutely open to the idea of having the implant as well. My GP is withhold my medication until I specifically have an IUD fitted.

Can you get an implant instead?

I'm going to discuss that as an option with the clinic and see what they say. The GP ruled it out on this basis that it's a hormonal contraceptive but I'd be a lot happier with than than an IUD.

I take Lamotrigine (for epilepsy) and my GP's were never very happy about prescribing me the contraceptive pill because they said Lamotrigine can reduce the efficiency of it and they didn't want to risk me accidentally falling pregnant on that medication.

As a result I had a Mirena Coil for the first time in 2010 (pre having any children) and I was happy to have one as I knew it was the safest in my circumstances.

You are absolutely within your rights to not have a Coil if you really don't want one but sometimes the medical advice is there for a good reason.