To be so annoyed with bloody paternalistic NHS

[MyKindHiker]

I am a lifetime migraine sufferer and as I'm getting closer to menopause they are getting worse in frequency and severity. At least half of all days I wake up with some form of aura, go through packs of nurofen and sumatriptan. Anyways it's been years since I considered any intervention other than just taking meds when one coming on (not necessary as not that frequent through adulthood), but I gather from talking to others there are some really effective meds available now which can prevent them entirely.

Go to GP who looks at recent bloodwork done to check my hormones and says as I'm still fertile and having periods, he can't prescribe in case I get pregnant while on them. I explain I have 2 kids and don't want more. In fact, can't technically have more anyway due to birth injury with second. And husband has had vasectomy to prevent accidental pregnancy as due to birth injury I could get pregnant but couldn't carry baby to anywhere near term. Which is beside the point as I do not want any more kids anyway.

Anyway doc says I still can't have the meds and the rule is for women of childbearing age the rule is they need to go to a special clinic with a 12 month waiting list and do all the steps first (elimination diet etc... I have TRIED THIS OVER 30 YEARS) and prove I'm not pregnant.

I mean what is with these people? If I was a man, I would have just got the meds to prevent a very debilitating condition. But because I'm a woman I can't have the meds 'in case' I become pregnant as though I'm just a uterus on legs who can't think for myself and decide not to become pregnant? Why is my word not enough that I will not have an affair with a non-vasectomied man and get myself up the spout. Ridiculous.

Will do 🌻

This isn’t correct. I’m 43, suffering with peri symptoms so just started HRT but also on the mini pill as have to take statins for familial hypercholesterolaemia and am currently still technically having periods and am sexually active with my DH. I’d go back and insist on contraception.

There's a lot to go through here.

You need to see a neurologist and a gynaecologist. Insist on it.

At least half of all days I wake up with some form of aura, go through packs of nurofen and sumatriptan

That's a serious issue. You are at risk of addiction, and you may already be there. You should not be taking this much ibuprofen or sumatriptan. Addiction doesn't mean that you get some sort of high on something - it's means your body develops a dependency on certain medicines and that could take a while to sort out.

It looks like the root cause is your hormones. Your GP or gynaecologist could prescribe you HRT to see if it works, but it may not be a magic cure, and it will probably be tough for you to convince them. HRT is sometimes used as a migraine therapy, btw. Less so in the U.K, I imagine. You won't be able to use HRT as contraception btw - this would purely be for your migraines or other symptoms.

A neurologist might be a little unfamiliar with that, but they will be very familiar with prescribing prophylactics, to prevent migraines. Be careful though - amitriptyline and others like it are old fashioned anti-depressants and doesn't exactly sound like a picnic to wean off. There's also increasing studies that link anticholinergic medicines with increased risk of dementia, so it's not ideal to be on something like that for a long time.

Also, in your case, I'd be concerned that this is simply masking a hormonal issue. This may not show on your blood tests though, so be prepared to be dismissed if they come back within 'normal' range.

Because people say all that but later when a proble. Happe s say it was t explained properly to them and then sure the doctors.

Or something happens to the patient and the family sues the doctors. Regardless of what was discussed.

It's not worth it for the doctor to put them self at risk.

Lots of news articles. Where doctors get sued for spurious reasons.

Where things have been explained to the patient then 2 years later they get sued for something that wasn't their fault.

I'm not surprised they won't prescribe it.

That’s mad, why should she do that? You make it sound like she could just pop into Boots and ask them to tie tubes for her.

I 100% get this perhaps if op had
proof she would definitely need to terminate pregnancy due to health anyway this could help? Because I agree there are no for women who are absolutely convinced and suddenly they’re pregnant. it seems to be particularly common when people get close to meno.

No it doesn’t - he’s not the only man who can get her pregnant.

Absolutely not and I'm not about to but my original point still stands. Of course there are wider implications but if a doctor lets a pt know about the risks and they have suitable contraception in place (vasectomy) then I don't see the issue.

Agree, sorry you have been treated like this

I BEGGED for a hysterectomy for 17 years. And medically speaking, I was eligible. However I wasn't allowed one in case "I wanted to have more children".

They do not give out hysterectomies just because someone doesn't want to get pregnant. Not when they are of child baring age.

Believe me, i tried and so have thousands of women before/after me.

Ah, so Op can't be trusted not to have sex with someone other than her husband then.

Sorry I wasn't saying it isn't used in women I know its used for epilepsy (my sister has epilepsy and has been on it). I've been on it for Migraine but for migraine they do try to avoid it if possible as for many it isn't even that effective, the birth control required causes additional issues for lots of women and mostly at least when I was on it, it was a second line treatment that had to be issued by a consultant neurologist, not a GP for migraine. Essentially GP's aren't able to initiate a sodium valproate prescription within the NHS.

I may have missed it but I haven't seen what the OP has previously tried for Migraine prevention but her GP should be able to try her on medications like Propranolol, Candesartan, Amitriptyline and even Atogepant which are usually used for at least 3 months prior to referral to a neurologist if these don't work. She could also get a prescription of Naproxen which can be useful and is more effective than nurofen for migraine and antiemetics if vomiting or nausea is an issue. Usually you have to try at least a couple of these before they refer you to a specialist so the OPs first step is to see a different doctor who will take her seriously and start her on a first line preventative. I think for propranolol at least birth control isn't needed, most will require something to be fair and I've mostly used a copper coil which has been acceptable to my specialists.

I went back on the combined pill age 47-49 as my oestrogen was so low on progesterone only. I didn't go through my GP and just paid for it on Superdrug private doctor, £30 for six months' supply. I felt so much better.

Endometrosis symptoms never recurred in spite of the oestrogen. Had the copper coil for five years in my 30s and that's when I got endometriosis, and had surgery to remove bilateral endometriomas. Apparently the endometriosis was everywhere, all over my bladder and attached to my bowel. Had never had problems with periods in my teens or when I was on the combined pill up to my mid 30s. The symptoms went away after surgery and going on the mini pill.

I haven't taken anything for 12 months now aged 50 and my periods have stopped. I'm not having any low oestrogen symptoms or endometriosis flare up and generally feel pretty good. Oddly I did have the first migraine with aura of my life six months ago, but have had nothing like that since.

This is enraging!!

Can you ask if you go on the pill if you’d be allowed it (you don’t need to take them).

The GP will have their hands tied by prescribing guidelines, if there's a risk of birth defects it'll have to be prescribed by a specialist. The real issue is the 12 month + wait to get any none urgent specialist appointment nowadays and the expectation to just get on with it in the meantime

NHS aren't interested in your morality, only your health and the high risk of tetrogenic effects some migraine preventative on pregnancy is one they aren't prepared to get involved in.

I think they're the same with men as well. They wouldn't give my friend a treatment for similar reasons as in his 30s, despite he has three kids already.

It’s not about his fertility, it’s about hers.

So much terrible advice on this thread from people who don’t understand the prescribing of these drugs.

If any of you are genuinely interested have a read of this https://gmmmg.nhs.uk/wp-content/uploads/2025/06/Topiramate-FAQ-document-FINAL-1.20.pdf

Trans men (bio female) can get testosterone even while pregnant because a deformed baby is an acceptable price to pay to affirm a trans identity.

But you can't get what you need. It is ridiculous and YANBU.

I can’t have hormonal birth control because it makes the migraines worse. This is really common. I’m in the US and my husband’s vasectomy with 2 clean post tests absolutely is sufficient for me to get topiramate. It was a life changer for me after many other things failed.

In the extremely unlikely event I find myself pregnant, I will be doing everything in my power to get an abortion as quickly as possible. The risks were explained when it was prescribed and if I wasn’t ok with that we would not have proceeded.

I absolutely refuse to get a hysterectomy because if it makes symptoms worse instead of better, hrt is the only option left and my experience with hormones and migraines is atrocious.

.

Am 46 and on the pill due to fibroids prescribed by gps

You absolutely can have hormonal contraception after 40. I am 47 and take degesterol for contraceptive purposes. I was on the combined pill until I was 44.

There are risk factors of weight and blood pressure to take in to consideration though.

I cannot believe people are blithely advising OP to go on the mini pill or get the copper coil! It's her body, and it should be her choice. They can outline the risks, sure, and if she's lying, so what? Why are the rights of a non-existent (and, more to the point, not going to be existent) baby more important than those of a living, adult woman? It absolutely IS paternalistic to insist on this despite the OP's circumstances. If they're really scared of getting sued, they could have something like a consultation to completely ensure that patients understand the risks before signing a waiver. But just saying "not listening to your reasons, you have to be on contraception" really is treating women like walking uteruses.

That is not how the prescribing of these drugs work.

I know, and I'm saying it should be.