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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

To think it's incredibly unfair my Trust have stopped doing female s terilisations?

171 replies

Thurlow · 02/01/2018 08:42

I was doing some reading before a doctor's appointment later today and it seems my Trust have made the lovely decision to stop offering female sterilisations and only offer vasectomies instead.

Only DP doesn't want to be sterilized as he's younger than me (I'm fine with this), and I've now tried the combined pill, single pill and implant all with side effects I'm not willing to spend my life coping with. If they don't suit me I doubt the Mirena will either, nor the coil because it causes heavier periods. I'm 38, I have two kids, I'm done. What does that leave, the diaphragm with its relatively high failure rate?

AIBU to think this is really unfair?

OP posts:
CheapSausagesAndSpam · 02/01/2018 08:50

Female steriliztion poses many risks which aren't generally known OP. I personally think that it's a bad idea for most.

a 2015 US study found that around 1 in 50 women who had a hysteroscopic sterilisation required further surgery due to complications such as persistent pain

And 8 out of 10 women get pain ongoing after the procedure and there's evidence that it increases the risk of endimetriosis AND that women who have Essure devices are often ending up having hysterectomies at a later date.

Original poster
Thurlow · 02/01/2018 08:54

But what's the alternative then if hormonal contraception doesn't agree? Surely women should be allowed to make an educated decision?

OP posts:
scaevola · 02/01/2018 08:55

Yes, I agree with you.

Is it completely withdrawn, or is it a case of limited funding (which does not meet demand) and so a waiting list ?

Trusts do want women to have mirena, because each one costs about £90 (plus fitting/removal appts) compared to vasectomy (about £500, but not the woman's body, so not her choice) or female sterilisation (about £3000). Reversible contraception also does not have the serious complications (which are typcially under-estimated for vasectomy, about 10%; and underestimated for female - which is about the same) which again also cost money to treat. Rationing makes complete sense from a health budget POV.

But of course that doesn't help you in the slightest.

You will either need to campaign for a change to your Trusts's spending priorities (and who knows how long that might take) or find the money to go privately, or try a mirena. Have you browsed in the contraception topic for more views about how MNers have got on with mirenas? It seems to be much commoner for periods to become much lighter/stop than to become heavier (as they often do with non-hormone coil).

pinkdelight · 02/01/2018 08:58

Can you afford to go private? Looks to be between £2k-3k from a quick google, which seems surprisingly low.

YANBU though, course it's unfair.

nooka · 02/01/2018 09:00

That's really interesting CheapSausagesAndSpam. I've only ever seen the stats for pain after male sterilization given, often in arguments about why women should be sterilized instead. The number quoted is usually 1 in 10, so 1 in 10 men in pain is thought to be worse than 8 in 10 women in pain!

Original poster
Thurlow · 02/01/2018 09:00

It seems to have been withdrawn except in 'exceptional circumstances'. I do have private insurance but I suspect it wouldn't cover this as it's not medical?

They've pushed the Mirena at me for years. I'm not keen on the procedure - 2 cs's so nothing has ever been there! - but also I suspect I'll get the same side effects as I do with other hormonal contraception. These are lowering my mood significantly and also a complete loss of libido. I'm not even 40, I don't want to spend my life and my relationship with no sex drive at all. So I could go through the pain of having the Mirena fitted just to have the same side effects?

I know there's no magic answer but it feels so frustrating that one option I could have made an educated decision about has been withdrawn

OP posts:
Iolaus84 · 02/01/2018 09:05

Can your gp not refer you to a different trust? From a health care perspective if nothing else is appropriate? Perhaps they are one of the many trusts that have had complaints/court cases over the complications from surgery and have decided to try and reduce elective surgery or maybe they cannot find an appropriate service to carry out the counselling. Hope you get it sorted with your Dr appointment later.

JacquesHammer · 02/01/2018 09:06

Thurlow I feel your pain. My trust won't allow me a sterilisation as I'm single and "might have another relationship and change my mind".

I want an ablation to deal with menstrual disorder. They won't do it as "I could still get pregnant afterwards".

They also suggested I rely on my infertility as contraception.

Long live the patriarchy

Original poster
Thurlow · 02/01/2018 09:09

Jacques Shock That's awful, I can't believe they said that!

OP posts:
Pootlebug · 02/01/2018 09:09

I agree that it is frustrating that the Trust has made this decision.
Just wanted to say that I also suffer low libido and poor mood on the pill and implant but minimal or no side effect on the mirena. I think the overall hormone dose is much lower

RavingRoo · 02/01/2018 09:10

Unlike vasectomies female sterilization is a major surgery and women can die on the operating table. I think it’s ridiculous thar you want such a major op just because you don’t want to use contraception.

greatbigwho · 02/01/2018 09:12

Same in my trust as well. It's really unfair.

dun1urkin · 02/01/2018 09:13

I can only speak about my experience, but having a Mirena fitted is only a bit more uncomfortable than having a smear.
I’m not going to lie to you, it’s not pleasant, but nothing a couple of painkillers can’t deal with (I have no DC, and understand this makes it more uncomfortable for me)
And there is a very significant difference between the amount of hormone in oral/implant than Mirena; it is not reasonable to draw conclusions about side effects as they aren’t comparable.
Good luck with your appointment

ThroughThickAndThin01 · 02/01/2018 09:13

I suppose it's unfair if other areas are still offering it, but I can understand why they've withdrawn it. It's hugely expensive.

JacquesHammer · 02/01/2018 09:13

I think it’s ridiculous thar you want such a major op just because you don’t want to use contraception

You do realise the difficulties contraception brings right?

Peachyking000 · 02/01/2018 09:14

Ask your GP to refer you to a different trust?

tabbywabby · 02/01/2018 09:16

If they don't suit me I doubt the Mirena will either
The hormone levels are completely different.

I have a copper only IUD and the heavier periods did settle down after a few months. Not everyone gets on with them, but I have used this method for 20 years (not the same one!) and love it. No hassle.

TammySwansonTwo · 02/01/2018 09:17

Unfortunately it's very possible that tubal ligation could cause the same side effects as hormonal contraception, or worse. If you look online there's lots of women talking about "post tubal ligation syndrome" which is not currently recognised, but that was the same with mesh.

I had the Mirena several years ago for endometriosis. It was a disaster and wrecked my life for a year until it could finally be removed. I know many many women who get on brilliantly with it though. I understand that there aren't many good options, I need a hysterectomy but not quite ready for it yet and struggling on with the pill in the meantime. Have you tried a low dose pill like loestrin 20? You might get on better with that.

Dancetothebeat32 · 02/01/2018 09:19

Hi just wanted to give you my personal experience with the mirena, I have had it in since April 23 2016 and do not have to worry about replacing until 2021. It has virtually stopped my periods apart from the odd spotting every now and then, my sex drive hasn't been affected. The procedure is really not that painful, a few minutes of feeling uncomfortable I took some feminax around half an hour before my appointment. I understand it's not for everyone and I was really reluctant myself at one point, but due to a pill failure which resulted in me getting pregnant and having to have a termination I didn't think there was another choice for me. I was refused sterilisation due to only being 31 at the time.

giddyupnow · 02/01/2018 09:22

I have copper coil which is astoundingly under-prescribed here - it’s my third one after having them in/out for pregnancies. I am a total wuss and the insertion is reasonably grim, but I was still at the clinic 10weeks post section to get it done as it’s so dependable and should see me right through to menopause.

It used to make periods more painful but not anymore or not the coil I currently have.

dun1urkin · 02/01/2018 09:22

Ask your GP to refer you to a different trust?

It’s not the Trust who makes this decision (re funding particular procedures), it’s the Clinical Commissioning Group (CCG), and the OP’s GP will belong to this group.

There will be a process to allow people to have procedures that the CCG has decided aren’t universal, but it’s unlikely that the OP would be supported to go for this as she’s not tried all the alternatives that are on offer.

giddyupnow · 02/01/2018 09:23

I don’t have mirena as contraceptive hormones don’t work for me.

MumW · 02/01/2018 09:24

I suffer from migraine which was worse with oral contraceptives so was told they weren't suitable for me.

I now have fibroids and unmanageably heavy bleeding. I was nervous of the hormone element of the mirena and really didn't like the thought of it but didn't really have any other options. I've found it to be ok and whilst I still get migraines, so far they seem to have become less frequent.

I no longer have heavy bleeding although I do get some light break through bleeding.

allthatmalarkey · 02/01/2018 09:28

Raving she has very good reasons why contraception hasn't worked for her. Read her post again.
OP I feel your pain. However, I would a) try the mirena as it's supposed not to affect you systemically in the way pills do. I had the implant taken out for exactly your reasons. As it happens the mini pill works for me and I can stop it if I need a break, but I would have tried the mirena coil if it hadn't as it's much less hassle than an op. If you have anxiety about having it put in or taken out really lay that on thick to get them to take you seriously. There might even be the option to be sedated. If you're prepared to go through an op, then you ought to be prepared to go through the procedures to have a coil put in and potentially taken out.

And then b) if mirena coil doesn't work for you and you've exhausted all of the other options, you and your GP should have enough evidence to go to panel with an application for funding under exceptional circumstances. Initially, I thought it was unfair that the funding had been withdrawn, but reading more I can see why. But this just means funding isn't routinely available. There is always the chance to apply for funding for something, e.g. IVF if you can evidence enough need related to cost effectiveness. Good luck.

BakedBeeeen · 02/01/2018 09:31

I agree with other PPs. Mirena coil releases low levels of hormones locally - ie in the uterus. It is not like taking a pill and for the drugs to be going round your system.
I have had copper coil and now mirena coil - I prefer mirena because periods are barely there now!
Also if you look at the stats, a mirena coil is pretty much the most effective contraception you can get.