To want a better explanation from my GP?

[popthecb]

I have head heavy flow for about 4 months now. None stop bleeding, days in the week where I'm flooding pads. Other days light spotting and then a larger bleed, nevertheless, every day I'm having significant bleeds and it isn't stopping.

I was sent for an ultrasound, both abdominal and transvaginal. Completely normal result.

I had a blood test which checked a range of things - all normal except I have iron deficiency anaemia

GP has now said he just wants me to start a tablet that stops heavy bleeding? (I've got to pick it up), and then he 'strongly advises' I try the pill

I did say I was hesitant to this, as I really don't like hormonal contraception's and don't want them. He said 'I do think it's best, I'll give you a prescription in case you change your mind'

So I've got a prescription for a pill too.

I don't want to start the pill though. He also then went on to say when I leave the room, I need to book in for a coil. As it helps with heavy menstrual flows in a lot of circumstances

But he isn't really listening :( I can't even tell what a period is anymore - they don't stop. Is it even a period? I wouldn't know as there's no pause

Can someone advise me? AIBU and time washing for insisting on no hormones?

Did he say that the pill is definitely a hormone related pill? There's a medication called transamic acid (sorry if not spelt right) which helps heavy bleeding. If not a coil is a good option.

@inheritanceshiteagain He prescribed the pill and something alongside it to take first, I think the medication you just said ^

Then he wants me to have a coil

But I don't want to be on the pill or have a coil fitted

He seems to think these are my only options? Is that really true? He seems hesitant to explain

why are you against taking hormones if they might fix or at least reduce your problem?

You must be so fed up!! I only had about 2 months of near incessant bleeding, light in my case, but it was turning into a complete nuisance. One nurse suggested polyp treatment for me but the wait lists just to start getting a treatment plan are > 1 year in some parts of the country, you want relief much sooner if at all possible.

Even if you responded badly to hormone medications in past, they might affect you differently now.

I think you need to weigh up what is more important to you:

Not being anaemic anymore

Or not having hormonal treatment

Unfortunately you aren't in a position of having the choice of both.

Your GP has given you up to date advice of tablet to reduce bleeding (likely tranexamic acid) and a Mirena coil. He's also told you that hormonal treatment would be most effective immediately.

Just because you don't like the GP's advice, doesn't mean it's wrong.

I do understand that, I just thought the way he was saying things was just not the full picture if that makes sense?

Surely there's something else I can try first?

I really don't want to be on contraception

Just to add, I thought the bleeding being so heavy and unexplained would require a gynae referral?

Surely they need to find out why this is happening?

If he hasn't explained why these are the treatments he suggests then make another appointment. With another doctor if you like. Every GP ive ever seen has explained why they are prescribing this thing and if I ask about another thing they tell me why they havent gone for that.

If no reason can be found medically then these are sensible options to stop you becoming even more anaemic and needing a transfusion. My DD ended up with one after her first period (unbelievable!) and went onto that medication too. It does help to reduce bleeding so try that first.

I imagine Norethisterone is the tablet to stop bleeding. It works

I also can't really take the oral contraceptive pill so I just stayed on norethisterone for a couple of years (was theoretically on the waiting list for Mirena coil but it has never materialised (covid waiting lists I suppose).)

Then ask. Go back and ask.

Might it be possible to see a gynaecologist privately who will be in a position to explain more fully what is happening and the whys of the options available to you.

It just doesn't seem right.

I can't have sex either it hurts my hips and pelvis!

I was desperately hoping to continue to TTC so really don't want a coil or pills

Have tried to voice this but he doesn't seem to address that

You don't mention your age but perimenopause is brutal for this kind of unexplained bleeding, the only good thing is that if it is you will eventuallly stop.

you have all my sympathies. i work in patient facing healthcare and had to change tampon, pad, period pants and incontinence knickers every 35 minutes at one point and became so anaemic I couldn't walk upstairs without getting out of breath. I thought I was going to die!

Ahh no you poor thing that's awful!

I am 25 so don't think I'm premenopausal

ah, you are young.

I think you need better and more specialist advice.
GPs can't be expert in everything, ask for a referral to a gynaecologist

GP could send a referral but gynaecology would likely ask the GP to do exactly what he's offered first before they'd see you. There's no reason he still can't refer but they will have likely asked for all those tests and use of contraceptives first to see if it helps before they get involved.

I've been on a wait for a gynaecology op for 2 years now and they said the back log was massive. Only just got in last week because they called and offered me a cancelled slot that was the following Monday.

My friends have both had something similar and the medication + contraception helped regulated their periods. Whereas a colleague had the same but she suffers with endometriosis and the heavy bleeds are caused by that

Do some research into endometriosis. The symptoms you describe sound like this to me. Go back to your GP armed with info and ask for a gyne referral. There is a long wait though and endo can only be found through a laparoscopy. I went private (luckily I have private healthcare’s through work) but still had to speak to 2 different consultants before the second took me seriously. They did find endo during my lap and I’m so glad I pushed for this and got answers.

Feel your pain . I bled for 2 1/2 months non stop heavy / spotting the lot because of the mini pill. Came off it in the end because it’s now caused issue with my iron and b12 .

Those tablets will stop the bleeding after a few days but it might start again once you stop them.

Would you be against getting the copper coil which is a non hormonal coil? Or try the pill for a few months at least to give your body a break from the bleeding ? Xx

Ìf I was you I would take the tablet (trans?) to stop the bleeding for now. If it comes back try the mini pill. I would do all it takes to get the bleeding under control for a few months, then go back to gp and say you want to ttc. But first things first, get the bleeding stopped and your iron/b vits stabilised .

I had this in my 20s. GP tried tablets to stop the bleeding (Ponstan Forte) , that didn’t work so I was put on the pill for 3 months and it settled everything down.

Endometriosis came into my head reading this. My friend was prescribed the pill for it as well which did help.

I think it's perfectly reasonable to want a referral to get to the bottom of why this is happening rather than just being thrown a prescription for the pill and told to get on with it. Bleeding heavily for months with no break is not normal and there must be a reason for it.

Tranexamic acid is not hormonal and it is not a contraceptive, I think you have misunderstood the GP. It is not good for your body and you won’t be able to conceive if you are currently bleeding constantly.

Once the bleeding is under control you will only need to take it at the time of your period to reduce excess bleeding. Treating this would not affect your ability to TTC and it would solve your anaemia, which would make your body healthier to support a pregnancy it you are successful.

Perhaps you could book in another appointment with the GP or a different (female?) GP to discuss it in more detail, while you await a referral to Gynae?

Get a second opinion.

You don't have to go onto any contraceptive you don't want to.