To ask what the best medical option for period management is?

[icantdoitalone]

I’ve tried -

The implant
Mirena
Combined pill and mini pill
Utovlan - northisterone 10 days each month (hell hell hell)
Decapeptyl jabs
Vit B6

Plus most low-mod opiate painkillers eg tramadol, dihydrocodeine, gabapentin, nortriptyline

Currently I’m being advised to have a natural period, take 2 dihydrocodeine at onset of bleeding then 1 4-6 times a day for maximum of 15 tablets, plus regular paracetomal and ibuprofen, and block 3 days off for sleeping it off .

This isn’t really sustainable and I’m also now anaemic from being too heavy (ie I’ve gotten through 3 packs of pads this month) . I’m finding I’m physically dreading the end of each month as I’m in agony .

GP is suggesting they re-refer for scans but thinks it’s just me - I have PCOS, suspected endometriosis and known adhesions . I’ve also got a bladder condition and they think periods are bouncing off that - possibly quite literally - and making things much worse in terms of pain .

Also said consider if I want to go back on hormone meds again, see if that helps..

Hospital won’t do surgery/diagnostic laps at the moment, saying there’s a very long waiting list and even if they did find endo they won’t treat it, they’d need to do another
Op for that with eg Bowel surgeon involved - so not worth thinking about it just now .

I don’t want another mirena - too painful and the insertion was hell - but wondering if others have found the mini pill works? Even just to get some control over when I’m bleeding would help I think .

OP, if you have any means to do it then go to a private gynecologist, even if for just 1 consultation. Unless you have a very sympathetic GP you are just wasting your time. You need a professional medical opinion if someone who is not prioritising NHS resources over your wellbeing

Is the main problem heavy bleeding or pain? Or both? Without a specific diagnosis, I would use tranexamic acid for reducing flow and mefanamic acid (Ponstan) for pain. You don't mention either of those in your list and I'm surprised at some of the hardcore stuff you've been given in preference. (NB that tranexamic acid doesn't work for everyone though.) If you are very anaemic, that should be treated too.

When you were on the combined pill, how was you taking it?

I usually take the combined pill back to back to prevent having a period at all

Is ablation an option? It won't stop endo but can significantly improve your period

It’s both the pain and heavy bleeding .

I was given ponstan years ago as a teenager and in my early twenties but suffer a lot with heartburn so think they were reluctant to try it again .

Would be happy to give tranexamic acid a go again though, I’d forgotten that one existed !

Yes they’re trying to get anaemia treatment started apparently, GP is ringing again on wed to sort out prescriptions for that thankfully

Combined pill i was taking for I think 3 (or 4) weeks then having a break .

They’ve mentioned ablation yes, I’m scared of doing that as haven’t tried to have children yet and scared of doing something that would mean I never could iyswim . Maybe worth discussing again though .

I used to have a depo injection every 3 months for endometriosis. This was years ago. No periods . I then did switch to mirana coil. I appreciate that the insertion for you was not good, are there times of the month when it might be less uncomfortable?

BTW this was before and after having children .TTC could not take anything, but fortunately did this after longer periods of depo which then reduced the wandering endometriosis to negligible. Breasteed eeo reduce symptoms too.

Ah sorry OP I assumed you had kids already. Apologies, of course ablation is not an option currently.
Hope you get some relief, fellow endo sufferer here, it is bloody agony.

I took the mini pill without a break and had no period while on it.

You can also take the combined pill without a break and have no period.

Mefanamic Acid should help with the pain. But would do nothing to ease the flow, could be helpful in the shorterm.

You need to go to your GP and be quite firm that what is happening is adversely effecting your life and it needs to be looked into by a specialist to figure out a cause and then solution. It can be hard to convince GPs (especially male ones) that awful period symptoms shouldn't just be put up with, but persevere. My own problems were only referred on when my pain was so great I had to come home from holiday early as it was unbearable, I saw a new GP at the practice (woman), she saw how many times I had been in perviously and referred me straight away.

If men had to suffer with and deal with period pain that there would probably be excellent pain medication to manage it by now. Women are told to put up and shut up.

I have pcos too. What works for me is what conquestempire said. That combination seems to deal with the pain and heavy bleeding.

@SummaLuvin you say that as if women don't work in pharmaceutical development...

OP, you have my deepest sympathies. I can't suggest anything that you haven't already tried, or has been suggested. I hope you find a solution soon.

My flatmate years ago had similar prob. She was told to take her contraceptive pill constantly , no breaks, for 9 months to give her body a break & them time to sort the underlying issue without such heavy bleeds making her general health so poor. It was a 6month wait to get endometriosis diagnosis in the end. I think she had some treatment for that but it was 18 years ago so can't remember what . She was worried re taking the pill all the time, but the Dr told her a lot of female Drs take the pill for 5months constantly then have a break ,so as not to deal with periods so often at work. No idea if that's still a thing or if it's advisable just for inconvenience reasons. Don't get fobbed off. My poor friend was in agony for 3-5 days every month & her life was miserable.

I had horrible pain and heavy bleeding (I would go through a super jumbo tampon in an hour) and I went on the mini pill which definitely made it lighter. Down side was there wasn’t any pattern to when I would bleed but it did settle down after a few months. Not having a period for months on end was epic!

Just having flash backs of being sick due to the pain, having to take time off school / work and bleeding for 9-10 days.....sending virtual hugs it’s rough!

Once your family is complete absolutely have ablation x

I’m childfree by choice and I’ve asked about ablation but they won’t because I’m young-ish and I “might change my mind about babies” 🙄

Have you tried taking the combined pill without a break? Tranexamic acid can help and depending on your medical history, mefanamic acid perhaps with stomach protection alongside.

The guidance has updated in the last few years for the combined pill - now it’s recommended as an equal option to take without a break, or only every 3 months if a patient prefers, there’s no dangerous side effects and it’s terrible that it took so many decades for this to be recommended as a safe option.

Pcos won't be giving you heavy painful periods, it sound more like endometriosis.
Make sure you are in the system (ie been referred to gynae) for when they start up doing more diagnostic laps
Until then if you could try decapeptyl you may find that your best option, not sure if you GP would prescribe this without the say so of gynae though.

I am an endo sufferer too. Wouldn't usually go private but in your circumstances if I could raise the funds I absolutely would. g
Not sure why they say you would need two laps. Mine was identified and removed in the same procedure.
I really hope you get it sorted. It sounds like torture.