To be unspeakably angry at the doctor?!

[showmethegin]

I have been having really awful, incredibly painful periods from the age of 11 so 19 years of agony. My GP finally relented and prescribed me naproxen which has helped. In the same appointment I explained that me and DP are TTC. After 3 months of relentless negative OPKs, wondering what the hell was wrong with me I've now found out that Naproxen stops ovulation for approximately 27% of women.

AIBU to expect the doctor to have told me that?!

I believe that mefenamic acid is another NSAID, but apparently tranexamic acid is not a NSAID.

As others have said, you need to be referred for gynae investigations, it's possible you have endometriosis (among other gynae/hormonal conditions) and you would need to investigate the root cause of your period problems - these are far more likely to interfere with conceiving than naproxen (though something like endo doesn't mean you 100% can't get pregnant!)

Mefenamic acid (ponstan) is probably a more appropriate painkiller. I'd honestly be more concerned that the GP hadn't gone down the investigative route than the fact they didn't have an encyclopaedia knowledge of possible side effects.

Women generally have to take charge of their own health when it comes to this kind of thing. Good luck OP X

It's not about making excuses - a few of us have just stated the fact that we didn't know that there was a small study done 3 years ago that implied but did not prove that naproxen may delay ovulation. I'm actually not a GP and never prescribe this drug in my daily practice but I still don't think its unreasonable for GP's to not know every little potential side effect of every drug.

I mean, in a ideal world of course it would be great if they did but we are only human sadly. It's not as if the information was known but been maliciously withheld - simply that it was not known.

I'm sure fertility specialists would know a lot more about this than me or a GP though.

Also as an aside, it is more commonly known that NSAIDS are not suitable to be taken in pregnancy as they are associated with increased risk of miscarriage in early pregnancy and birth defects in late pregnancy (probably ok in second trimester though if absolutely necessary). So the GP probably should have mentioned that although I presume they assumed OP wouldn't be taking them in pregnancy as they were for her periods.

Is naproxen prescription medicine in the U.K.? I buy it over the counter in the Netherlands, it's the only thing that hells when I have a bad period.

I strongly advise you to always, always, always read the information leaflet.

I think maybe a lot of people don't fully understand how these side effect listing on drug leaflets work. They have to list all ever known side effects, even if they're really really really rare. Like, so rare that a GP doesn't routinely know about them and even if they did they probably wouldn't routinely mention them.

This condition is rather difficult to diagnose there was a bit on the TV news recently of a woman who had suffered this for years and it seems it was either found by chance or someone in the Gynae dept knew a bit more about it than most anyone else!.

To anyone downing NASID's. Naproxen and Ibuprofen, on a regular basis you should be taking somethinmg like Omaprozole to offset the nasty effects of them to your Kidneys and stomach.

It shouldn't be too difficut to look up side effects and contra indications etc these days with the IT avaiable:)

Did i say NHS IT;??

@JinglingHellsbells I did RTFT thanks, the OP did not ask the doctor if the medication was ok when TTC, if they did the Dr would have checked for her, Dr's do not know the side effects of every medication. The OP should have read the leaflet before which helpfully starts with, Read all of this leaflet carefully before you start taking this medicine because it contains important information for you. before starting the medication.

It took me a while to find it on my leaflet but it's there. I'm still ovulating as far as I know but when I stopped taking it right in the middle of my cycle I got a random period, which seemed very odd.

Another doctor here who had never heard of that.

Sorry you’ve been through this.

Doctors certainly have a responsibility to inform you of the most common side effects, but not EVERY aside-effect. That’s why there’s information sheets.

Yes, YABextremelyU. Take some responsibility for your own health and read the patient information leaflet before you start taking a new drug.

I am having a miscarriage and my sister gave me some of this drug in case I needed it (only 3 tablets which she had spare, which I haven't used). I assume she didn't know this side effect or she wouldn't have given it to me. She is a doctor.

I can see why you're upset. I would be too. My GP told me to buy a throat spray from the pharmacy for my tonsillitis (to go with antibiotics) knowing I was breastfeeding, and I asked them are they sure it's ok to use and they said yes. I checked with the pharmacist and they said there is no way I could have that while breastfeeding as it would stop me from producing milk.

I would say always check with the pharmacist as they know best. Sorry this happened to you. Hope you're ok.

Thank you for all your responses. My title was potentially a bit OTT, I'd just found out so was quite shocked.

I have been suffering for a long time and for a long time was fobbed off which I took because I do respect doctors and the NHS am aware that they are human and get very little time to treat patients. Plus also a bit bloody naive and was led to believe 'its normal, periods can be painful'. I then hit a bit of a wall and realised it's not normal at all and pressed my GP more. I had an ultra sound (plus an internal) and they said there was nothing there to suggest endometriosis. I don't seem to have any of the other symptoms so was satisfied with the ultrasound. (Helpful posters on here have suggested that an ultrasound doesn't always work to diagnose this so for this reason will go back to the GP, so thank you).

In response to the valid points of why didn't I read the leaflet. I did scan it, as you do but just didn't spot that so obviously that's on me. Part of me didn't even dwell on the idea that that could be a side effect as the predominant point of the appointment had been TTC and getting my ducks in a row regarding that, including coming off Citalopram which I have now done when the doctor explained the side effects of that regarding pregnancy. I also didn't realise that it was such a small study (still is concerning potentially though.

I also take into account that 3 months TTC in the grand scheme of things is nothing and appreciate that other people really struggle so am not in anyway minimising that.

@showmethegin - I'd be interested to see the reference for that fact. I've been a GP for 14 years and have never heard it.

How much naproxen did you take? Two tablets for 2-3 days at a time? That isn’t high dose or prolonged use, I wouldn’t look at it as cause for delay in conceiving. Good luck with TTC.

I also tried mefanamic acid as pp have suggested but unfortunately for me did absolutely nothing

Is it this study?

www.sciencedaily.com/releases/2015/06/150611082124.htm

There were only 39 women in it. Is there any other evidence, larger trials etc?

Never heard of this as a side effect you learn something new every day!

Yes I'd be frustrated at finding this out, but don't think the Dr necessarily knew so more than likely a case of human error

Drs deal with so many patients and so many medications it can be hard for them to keep track. That's why we get the patient leaflets in our medications so we can fill in the gaps where the Dr misses things.

If this was a gynae I'd be angrier as that's what they specialise in

GPs have to deal with everything
Instead of pain relief id have asked for a referral to gynae who will be better able to advice you

How do you know you are not ovulating? Are you temping? Did you confirm you were ovulating previously? Are you still having periods?

I haven't had a positive opk as yet. I have a very long cycle (36/37 days). I've bought a thermometer to start temping. Pardon my ignorance on it, it's all very new and it's a steep learning curve isn't it!

OK. Get a copy of Taking Charge of your Fertility. It's really invaluable for understanding your body.

OPKs do not mean you are or are not ovulating. Long cycles are fine - mine is at least 33 days and it just means I ovulate later - usually on day 19 or so. I've had cycles way longer than that before too.

If you are continuing to have periods as normal, it's very unlikely that this medication has stopped you ovulating if you already were. Either you may not ovulate normally (common with PCOS) in general or, if you have regular enough cycles, chances are you are ovulating fine and just not catching the LH surge. Some women's last only a few hours. Some never get a positive OPK. Some get multiple positive OPKs a cycle. BBT is the only way to know if you're ovulating or not, short of ultrasounds. For most people, if they have regular periods while not on birth control, they will be ovulating.

I didn’t know that. And I prescribe a lot of pain relief.

I eventually found reference to its fertility impact on the Summary of Product Characteristics- however it took some finding, and before I retired I did a lot of looking at SPCs. There was a bell ringing for me due to the effect on prostaglandins.

Fertility:
The use of Naproxen, as with any drug known to inhibit cyclooxygenase/prostaglandin synthesis, may impair fertility and is not recommended in women attempting to conceive. In women who have difficulty conceiving or are undergoing investigation of infertility, withdrawal of naproxen should be considered.

OPKs aren't evidence that you are or are not ovulating. Are you continuing to have periods as usual?

That's not really true. If you're using OPKs properly they're often the first indication women have that they're not ovulating if they never, ever get a positive one over months. Certainly that was the case for me which was backed up with temping and later a diagnosis. Periods are a bit irrelevant. I don't ovulate and have regular periods.

I've just looked in the BNF.

The warning is "long term use of some NSAIDS is associated with reduced female fertility, which is reversible on stopping treatment".

I have not been aware of this warning until now and I also prescribe a lot of analgesia (but primarily to children who one would hope don't try

However my pedants mind questions whether taking it for a few days each month long term usage? Or is it regular short term usage? I would want to look at the studies and haven't found much.

The expectations on GPs are actually ridiculous 😂 expecting them to know every NOT ACTUALLY PROVEN side effect of a drug, rather than read a sheet yourself. For a GP that is thousands of drugs. Would you not prefer we prioritise highlighting the actually proven and/or harmful side effects??

🔨 here's a hammer in prep for the next doctor bashing thread.