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 hope he’s also utvuou on omeprazole for your tummy as Naproxen can cause ulcers

Ask your go for bloods, my periods were horrific and madly irregular, heavy, painful and I would vomit/faint most times.

Fast forward several years and numerous ‘it just is’ from GPs, and we started to ttc. 6 months of tracking and 2 periods at age 33 and the blood test showed hypothyroidism - within a month of being on replacement therapy (levothyroxine) I had normal periods.

You can only ask! And you don’t have to be overweight for it to be thyroid.

I used to take that and they really stress a stomach protector to be taken with that as it can cause ulcers and stomach bleeds. I'm sterilized so they never mentioned any other side effects to me.

Isn't it much more likely that the underlying cause of your dysmenorrhea (be it endometriosis, PID or whatever) is the cause of your fertility problems rather than the naproxen?
Another GP who had no idea - but can't be expected to know the 200 side effects of this one medication off by heart!

Your doctor probably didn't know that - unless it's listed on the medication side effects list, why would they know? I'd research an alternative and go in armed with the relevant print-outs. I can understand why you are angry and upset about it though.

It's unfortunate, and if the doctor had known I'd hope they would have checked if you were TTC (although Hiphopopta makes a valid point), but to be honest I think the responsibility lies with you; you should always read patient information leaflets thoroughly before taking new medication.

The onus is on the GP to check when they know someone is trying to conceive. She told him. He ought to have researched; took me less than 5 mins on google

LOL - if only it were that easy. A typical GP probably prescribes around 300 drugs per day, if you include repeat prescriptions and consultations. So a quick 5 minutes Google for each would take 25 hours.

In any case, if the OP's GP had checked in the BNF, the medicines' "bible", it says only that some non steroidal drugs can cause reduced fertility with prolonged use. There is nothing to suggest that taking it for a few days per month would affect fertility.

It’s unreasonable to expect a dr to know all side effects of all medications. This is why there are information leaflets in the box.

I was once given a fairly mild anti emetic in an IV when in hospital. One of the side effects is that it can cause an elevated heart rate. I already have atrial fibrillation and my heart rate shot up to 170 bpm in about 30 seconds. It was terrifying. I rang the bell and while waiting for someone to come I looked up the side effects of the anti emetic online and knew them before the nurse actually arrived to speak to me. It happens on rare occasions apparently but it happened to me and now I have unable to take this particular drug on my chart. The drug was given innocently. The side effect was minimal and given the amounts of drugs the staff have to administer while I hope that they had some inkling of the side effects I am also aware that sometimes certain side effects can be rare and as such they can’t know all of them.

Bearing in mind that some drugs even include potential death as their side effects but generally the benefits outweigh the possible (and usually unlikely) risks.

I take some fairly hefty medication and I know the side effects of them all. But generally if you read the leaflets and knew all the side effects of all the drugs you’ve ever taken you’d never take anything ever, but that’s just not how it works.

Are you aware that you can buy Naproxen over the counter and at the dose recommended for period pain?
Can I write a
AIBU you wasted nhs time and money for something you can buy at boots???
Ps, i can empathise with the pain side as I am also a horrendous period pain sufferer that leaves me crawling on all fours,vomiting with pain.. and sadly cannot take nsaids or a lot of other meds in the positive side at 46 they won't be going on for much longer..... I cannot sympathise with you requesting drugs you can buy at your supermarket...

Op, do you expect all doctors to know every side effect of every drug and know every patient’s medical history and whether or not they are trying to conceive? All in a ten minute appointment slot?

I had horrendously heavy, 8-day periods for about 30 years, as did my mother and sisters. It was only when I was trying to get pregnant that I found out it was due to having large endometrial cysts.

I went to see a Chinese fertility doctor for acupuncture to help me conceive. That didn’t work, unfortunately. However, the doctor asked why I had put up with such ridiculous periods. I said I had assumed pain and long periods were normal. She gave me weekly fertility acupuncture - and I never had a single period pain again. They also went from lasting 8 days to only 2 or 3 and I barely noticed when they came and went! May be worth having an ultrasound? Acupuncture too? Just an idea.... Would mean you don’t have to take any more painkillers! X

Another GP (trainee) with no idea about this! I can’t find any convincing evidence that taking for a few days a month would influence ovulation, but certainly something I’ll bear in mind. I think it’s more relevant for long term regular use though. Sorry it took you so long to get investigated for your pain. I think some people have pretty unreasonable expectations though about us knowing all rare / suspected side effects, especially non dangerous ones.

I think being unspeakably angry at a doctor is not acceptable in first place. Unless you truly believe that your doctor has intentionally given you Naproxen to stop you from ovulating. Do you ?

The current edition of the medicines bible, the BNF, is 1616 pages long, of very small type - and that's just for adults. There's another edition for children. Around 80% of the drugs in both books can be prescribed by GPs and almost all have dozens of possible side-effects listed. We're probably talking about 100,000 possible side-effects in total. If you can remember that lot, OP, you're a better woman than me .

When it says "always read the label" on your medication packet, that it is what it means and it's there for a reason. It doesn't mean, "Ignore this warning, abdicate responsibility for your own health, then get furious at your GP for not warning you about a possible side-effect that probably doesn't even apply in your case".

I’ve been in naproxen for ages and no one has ever told me that?! It’s not in my leaflet in the box.

As I've said, I wrote the title in shock and have admitted it was over the top. And to the previous poster that said I was unreasonable for wasting NHS time; really?! How the hell would I know that you could get naproxen over the counter? I'd never even heard of it before I was prescribed it! And as my previous posts have stated I have suffered for years, would you be telling someone that had suffered chronic pain for years and years for something other than painful periods that they were wasting NHS time?

Thank you so much to all the posters that have offered advice re getting further investigations done, you've given me the confidence to ask now and an appointment is booked for Friday. Thank you!

Xxstatic - But by relying on a patient to read the label isn't the doctor abdicating responsibility to the patient?

What about patients who have dyslexia, visual impairments, dementia etc etc? Can they not rely on their doctor to make sure medication they are prescribed won't have negative repercussions for them.

People are entitled to turn to professionals for advice and rely on that advice. That's not abdicating responsibility.

GP stands for general practitioner, they aren't supposed to know everything about every drug.
Read the leaflets, check online, ask a chemist, don't rely on a gp to know everything.

OP for what it’s worth I could never get a positive on cheap OPKs despite trying for several months. I was despairing until I switched to the Clear Blue digital ones and got a clear positive every cycle until I conceived. It may be that you are ovulating but just not picking it up on the tests.

What about patients who have dyslexia, visual impairments, dementia etc etc? Can they not rely on their doctor to make sure medication they are prescribed won't have negative repercussions for them

Doctors should be aware of the major contraindications and side-effects, particularly dangerous ones. If the OP had a raging gastric ulcer and the GP had prescribed her naproxen (which makes ulcers worse), that would be unacceptable. But no doctor, even a specialist, is going to be able to remember and warn patients about every single small print side-effect.

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

The information is clearly listed in the naproxen SMPC: 'The use of naproxen may impair female fertility and is not recommended in women attempting to conceive. In women who have difficulties conceiving or who are undergoing investigation of fertility, withdrawal of naproxen should be considered'. If a GP isn't capable of finding basic information such as this within minutes and counselling your appropriately then I would question how fit they are to practice. The EMC website can be accessed within seconds.

Misses point of thread but can you buy naproxen over the counter?

3 months isn’t really enough time to be worrying about ovulation and the NHS won’t investigate lack of ovulation til at least 12-24 months of trying and not conceiving. If you are having painful periods then you need to get these investigated. Periods usually follow ovulation though. I had a lack of ovulation and knew this as I had a lack of periods for months and months on end. Eventually ended up with a referral and lots of tests and scans and disnfall pregnant naturally waiting for a diagnosis - which later turned out to be PCOS.

As a teen I had long painful periods and was put on the pill to counteract this - long with my bad acne. I went months without periods and then had very long painful one and very irregular. However once I came off the pill 15 years later the heavy long periods had vanished.

There are a umber if reasons for painful periods so ask for a gynae referral however getting to the bottom of that may also put your ttc on hold. My sister was investigated for endometriosis as she had similar symptoms but an endoscopy (or whiceve internal cancer thing they do) showed up nothing. She never got to the bottom of it but did have one child and gave up trying for a second.

I'm a nurse and did not know this was a side effect.

In all fairness, NSAIDs are first-line medications for severe menstrual cramps. Did your provider KNOW you were TTC? Infertility isn't necessarily inherently dangerous, so not usually high on the radar for side effects.

It’s the law that prescribed medications need to have the patient information leaflet in it, it is worth reading through when starting a new medication.