To be annoyed that my GP doesn't want to give me the pill?

[AVirginLitTheCandle]

I realise he's just doing his job and I probably am BU but I just need to vent and hopefully get some advice.

I have taken the pill on and off over the past 11 years with no problems however my dad has suffered two blood clots over the past couple of years. Because of this the GP is now reluctant to prescribe me the pill as he feels it's too risky.

I'm annoyed but now I have no clue what my options are. I have just recently entered a new relationship and I don't want to rely on condoms alone. I had the implant a few years ago and hated it - mood swings, depression, heavy and painful periods, etc. So that's out.

So what does that leave? Mini pill, coil (no thanks!) or injection (which is what GP is pushing me to have). I've read up on the injection previously and it just sounds horrible.

Arrggh, I want my pill, damn it!

You might be better off at a proper contraceptive clinic op. I found both for myself and dds lots of GPs arnt the best at contraception.

Can people recommending the ring please check their information before they post? It contains both oestrogen and progesterone so is a combined preparation, like the oral contraceptive pill..

Progesterone-only preparations along with a barrier method are your best options if a coil is out of the question (and especially if you are in a new relationship). However if the implant didn't suit then I'd recommend avoiding the injection. At least with the progesterone only pill you can stop it quickly if you have any side effects.

Re: insisting on the pill; would it be bad to go over this again with GP/FPC just to make sure they won't prescribe the pill to me?

I had no problems with the pill and I'm wary about trying other things with hormones especially with what happened with the implant.

I had the injection and lost 3 stone... I couldn't afford to lose that. I started at 9 and a half stone. Drs expressly told me I wasn't allowed the implant as a result because it had the same hormones.

Mirena on the other hand... loved it.

AVirgin - you could ask, but I'd be very surprised if you found any HCP willing to prescribe you the combined pill. Your family history of having a first-degree relative with a history of a blood clot at a relatively young age means the risk is classified as UKMEC 3 - the UK Medical Eligibility Criteria category where the risk of that method is considered to outweigh the benefits. It could only be prescribed where there are no alternatives or the alternatives are not acceptable.

For you, there are alternatives not yet tried so the GP/FPC would be very unlikely (in my professional opinion) to prescribe the combined pill.

Was just going to post what Sidge has.
First degree relative with DVT under 45 is UKMEC 3.

Look at Jaydess

When you have a coil fitted how long is the speculum up there for? It hurt when it was only in there for a few seconds during a smear test and I think a coil fitting takes at least 10 minutes. Ouch!

I really don't want to use condoms but I wouldn't really feel safe just using the mini pill alone so I feel like I would have to double up. I know that's probably illogical though and just me over thinking things.

I take the pill with family history of blood clots.
However I am a healthy adult, and both my grandfather and mother have been seriously overweight and unfit all their life's so I go with the impression they have them from their health not genetic.

My coil fittings have taken seconds not minutes

I gave a genetic clotting disorder and high risk of blood clots, currently have the mirena coil in, fitting took about 10 mins, hurt a bit and took a while to settle but fine now, GP said no pill, injection or implant for me either

I am going to repeat myself and say again that the cervical cap is fantastic. I have never used anything else and I am now 51, with no unwanted pregnancies. I figured out how to use it with very little trouble, and I was responsible about using it. Someone earlier in the thread said that it isn't reliable because people don't figure out how to use it, and perhaps this is true statistically looking at a whole population, but you could judge for yourself if this applies to you!

For me, it worked perfectly: no side effects, no discomfort, no hormones. Extra benefit- you can have sex during your period with no mess, as it is a cap which fits over the cervix and keeps the blood from coming out for a few hours...

Read about the cervical cap. So you literally stick it around your cervix ? Does that not hurt?

For future, know u can ask for a child sized speculum so smear test more comfy

I don't like making decisions.

Isn't a child sized one just the same as the smallest/virginal speculum?

www.nhs.uk/conditions/contraception-guide/pages/iud-coil.aspx#Having

According to that it takes about 15 to 20 minutes to have a coil fitted.

YABU, I'm afraid. I understand it is frustrating when something has worked well but If your dad has had 2 blood clots then statistically you are at higher risk of developing blood clots yourself and taking the CHC will increase that risk further. If you have other risk factors in addition to your family history (e.g. smoker over 35 or overweight, certain medical conditions or on some medications) then this can increase your risks even more. It can be complicated if your dad's clots were caused by something specific (e.g. post major surgery, or if he developed a clot whilst suffering from cancer) as this may change the level of risk.

However, if your GP prescribes the combined pill and you go on to have either a DVT or PE (and especially if you have complications) then he or she could be help responsible and judged to be negligent in the medical care they provided. Much of this is outlined in the UKMEC criteria (www.fsrh.org/standards-and-guidance/external/ukmec-2016-digital-version/), which are evidence based and provided by the faculty of sexual and reproductive health. Your GP is just trying to be safe, but they should be offering you alternatives.

A PP mentioned the vaginal ring but I would be surprised if this is an option as it is a combined hormonal contraceptive and both this and the combined hormonal transdermal patch are categorised in the same way as the combined pill in the UKMEC, so risks are quoted as the same for the pill, ring and patch.

Realistically, your options are: mirena; copper IUD; POP/"mini pill"; or the repo injection. Contrary to the views of some posters, I would say that if you had problems with the implant, you may be ok with the depo injection or mirena, even though they all contain a progestogen (it's not the exact same hormone, variation on a theme). I have had women who have not tolerated one of these methods at all well but have been absolutely fine on one of the others. Not all women find having a coil fitted painful- some do and many don't, there really isn't a hard and fast rule, despite what you might read.

If you are not happy with the GP decision you could ask them to write to your local sexual health clinic for advice/second opinion or refer you there. They will be happy to provide advice.

sorry- that should be depo injection not repo injection!!

Other non-hormonal options would include diaphragm/cap or condoms. Both of these are statistically less effective but this is due to user error (i.e. not used properly or during every episode of intercourse). If you can use it properly and reliably, they are a reasonable option.

I have also come across women using natural family planning, but you do need to be very organised, vigilant and totally committed if you are going to do this, so it's certainly not for everyone. Again, statistically this is less effective.

Sorry I haven't had time to read the whole thread but definitely do careful reading about the vaginal ring. It is not true that it is not linked to blood clots and in fact may have an increased risk in comparison to the pill. I have had the copper IUD, inserted before and after having a baby, it's not that painful to insert

OP- no you would not be wrong to ask to discuss this again with your GP. You may have to accept that he or she will not prescribe the combined pill though and I can see why. As I said in my previous post, you could ask if the GP would write to sexual health clinic for advice or refer you there (or you could go to one of their drop in clinics if you prefer)- always happy to provide advice.

I feel a bit stupid actually. I had no idea there were so many options.