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?

FWIW as another data point I found copper coil insertion pretty easy (doc who did it actually trains other doctors in coil fitting), though I did have a lot of spotting for the first few months on it and heavier periods. Periods have settled down now and I really like it, I get a variety of vile side effects on hormonal contraceptives.

I had an IUD and it was fine. I had a little bit of cramping starting about 30 mins after insertion, and this lasted all day. It wasn't severe and didn't stop me doing anything I wanted to. The next morning I woke up in no pain, and it's been fine ever since.

I really appreciate your feedback on how it's been for you guys. Just hearing, 'actually, it's been fine' is making me think more rationally about it now I've got over the initial shock of being faced with little to no option.

As is the usual way the only stories I've had from friends who've had this done have been friends who've had horrendous insertions, terrible side effects or conceived with it in place. Needless to say, I know it's coloured my view and left me petrified of having it done.

But the consultant hasn't prescribed your medication, he has recommended that your GP prescribe it. Your GP is medicolegaly responsible for his own prescriptions, and he needs to make his own professional judgment about the safety of prescribing. You can of course seek another opinion from a different GP.

I've got a copper coil and can honestly say I've had no side effects whatsoever. The procedure took five minutes too.

What about condoms, diaphragm and using a fertility monitoring device?

I LOVE my coil! It's my third one... First one taken out because I took a funny notion something was wrong with it (there wasn't in fact, but just to demonstrate that they certainly took mine out for me on the flimsiest reason on an appt made that day), second removed to conceive, third put in recently after c section. Painkilling gel, 2paracetamol as breastfeeding, no issues at all. Boom, that's me covered for the next decade. Also had depo provera, sparked major depressive incident lasting years, medication, therapy bla. For me, synthetic hormones in my system have a much worse effect than five minutes of fiddling and a metal wotsit in my womb. Sorry it's so stressful for you

Also heard about [this metro.co.uk/2016/04/13/this-app-is-just-as-effective-as-the-contraceptive-pill-at-preventing-pregnancy-5812994/] which sounds good for peace of mind?

Sorry link fail!

Isnt metformin used for type 2 diabetes?

I really didn't get on with the Mirena, migraines and two weeks on, two weeks off of bleeding for 8 months. However, getting it fitted and removed wasn't painful at all.

'Isnt metformin used for type 2 diabetes?'

It's also used for PCOS.

Your GP is medicolegaly responsible for his own prescriptions, and he needs to make his own professional judgment about the safety of prescribing. You can of course seek another opinion from a different GP

This. I'm not a GP BTW. Anything your Dr prescribes you he is responsible for- even if it has been recommended AND he has counselled you as to risk vs benefits AND you have agreed to go ahead knowing this. If there are complications as a direct result of the medication you are given and those were predictable and serious, then technically they are responsible in the eyes of the law. So if your GP has concerns, he is right not to prescribe in those circumstances.

There are a number of medications like this (isotretinoin for acne, for instance).Also agree with previous poster who is obs&Gynae Dr- depo/nexplanon not ideal if you have PCOS and want to take metformin.

Equally, your GP should have pointed you in the direction of another Dr who could, if they are comfortable, prescribe you the medication you wish with no "reliable" contraception. I suppose he has, in that you are going to see a sexual health (or equivalent) clinic.

So if your GP has concerns, he is right not to prescribe in those circumstances.

Not if those concerns are based on his personal preferences and dont take into account the patients right to make an informed choice about her treatment. And not if those concerns are based on a belief that the op is a silly woman who can't be trusted to take care of contraception and that he knows best. The OP is entitled to sufficient information to enable her to make a valid and meaningful choice. He has chosen not to give her that information.

I'll definitely be going back to the coil when I'm done having babies. I don't get on with hormone-based contraception and dislike condoms and for the minor discomfort of having it installed the payoff in terms of zero-hassle and highly effective contraception is 100% worth it.

Again, if you really hate the idea get a second opinion. I'm sure someone else will prescribe. Or don't have the treatment. But you really don't need to get freaked out by the idea of a coil. If you wouldn't be freaked out by a dental filling, it's no weirder than that.

(Off-topic but I always referred to mine as 'the widget', after that 90s Jack Dee advert for John Smiths bitter in a can )

Blistory

If the GP's opinion was purely based on his own opinion, not backed up by evidence or guidelines, then you would be correct.

However, when there is a known risk of taking a medication/set of medications together and so on, and where that risk could lead to a severe complication a Dr is not obliged to prescribe medication which is requested by a patient- even if the patient understands the risks and is happy to take those risks.

For instance, there are circumstances where women want to have a combined hormonal contraception but this is not safe (e.g. complex migraines, personal or very strong family history of venous thrombo-embolism/some oestrogen sensitive cancers, raised blood pressure and so on). I would be highly reluctant to prescribe medication in those circumstances ( and in nearly every situation would not) even if the patient understood those risks and still preferred COCP to alternatives such as POP, mirena or depo. I have been in this situation and refused to prescribe because I can (and most likely would) be held responsible for prescribing unsafely, even if it is done at the patient's request, the patient says they understand the risks and are happy to proceed.

It's not about "silly women don't know what they are doing when it comes to contraception". If the GP has valid concerns (and it seems he does), he is correct not to prescribe the medication.

However, the Dr should have directed the patient to another Dr for a second opinion. This Dr could then prescribe the medication if they were happy to do so. It's not enough to say "IUD or nothing, go and get it sorted"- he should have said "not happy to prescribe for X, Y, Z reasons and I recommend a copper IUS. If you're not happy to proceed as I recommend, then please see a colleague for a second opinion but in the meantime I am not prepared to prescribe you metformin".

expatinscotland i didnt know that, i havent taken it personally, my mum has type 2 diabetes so i know she takes them.

I have an IUD. Insertion was bloody painful until the HCP used anaesthetic gel. After that, it was fine. My periods since haven't been painful, although they are heavier.