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.

Utterly ridiculous. Her husband has had a vasectomy - she is not going to get pregnant! The likelihood is absolutely miniscule.

Yeah because no married person has ever had sex with someone else 🙄

@Naws Not up to her GP to make the decision for her though; just point out the risk if she was to (cheat and) get pregnant. The OP is a grown woman, and can easily avoid pregnancy in this scenario. The GP is treating the OP as if she is stupid.

Right, so the doctors are just assuming that she's going to have an affair, and in doing so, won't take any contraceptive precautions despite being very well informed of the risks.

According to the guidelines, having a female sexual partner is considered good enough as 'contraception'...but what if the woman is bisexual, and has an affair with a man? What if a woman's IUD comes out and she doesn't realise until too late? What if her tubal ligation fails? There is no guaranteed 'no-fail' method of contraception aside from hysterectomy or menopause.

At a certain point, with all warnings given and forms signed acknowledging the patient is aware of the risks, doctors need to treat women as though they're not total imbeciles who will leap straight onto the nearest penis and impregnate themselves. It's insulting.

It's up to the GP to make the decision to not leave themselves wide open to being sued.

Right, so the doctors are just assuming that she's going to have an affair, and in doing so, won't take any contraceptive precautions despite being very well informed of the risks.

No, but you know this.

I'm not quite sure why you'd make that up?

No-one is assuming anything, they're simply trying to prevent themselves from being sued.

But I guess you know that too.

@Naws Could I sue my GP if I developed breast cancer if I started HRT?

Yanbu, it's revoltingly paternalistic, and the scolds on here have truly drunk the NHS koolaid. If course you should be treated as the responsible adult you are.

Dunno, you'll have to ask them.

@Naws The answer is no. Because I would have been made aware of the risks of taking HRT - increased risk of breast cancer etc. So why doesn't the same apply here?

Frankly, I'd be surprised if a suit against the NHS was successful if the doctor has fully informed a woman of all the risks and made sure she understands them, and that if she intends to have sex with anyone other than her sterilised husband she will need to use a highly effective contraceptive method herself. But then I am not a lawyer!

Really though any form of contraception could fail. Would a woman be entitled to sue because her tubal ligation failed and she got pregnant while on tetarogenic medication?

At a certain point, informed consent along with some form of reliable contraceptive needs to be enough. It's sexist to require women to jump through hoops and undergo invasive procedures entirely unnecessarily.

Haven’t read the whole thread but in case helpful OP - I had great success with beta blockers for persistent migraines and tension headaches. I took a low dose daily for around 4 months, maybe worth asking about as an alternative.

OP has already said she cant carry to term so would have to abort anyway. So she's not going to be having a baby.

Try & see if you can get into well woman clinic that might help they may be able to sign post you to further help. I started to get ocular migraines at the beginning of menopause I was started in low dose noratryptaline which stopped them, in hindsight it could have been caused by raised bp or autoimmune disease that I have, also deafness. Medication has worked for me.

As I said upthread, it’s not beyond the wit of man to put in place a process whereby it can be documented that the patient has had the risks explained to them and can then sign to legally affirm that they understand them and accept responsibility if a pregnancy occurs.

Perhaps you’re not aware of how difficult it actually is to sue the medical profession in this country for negligent prescribing and win. It’s something that we’ve taken legal advice on and the long and short of it is that if other doctors would have prescribed similarly, then your case won’t go anywhere. Even if it would be harmful in each case and even if there was already research/red card info in the public domain that should have told the prescriber there could be an issue. It’s all stacked against the patient.

And yes, I can complain at how the rules have changed, because they discriminate against women and leave them to suffer simply because of their sex, whereas men are able to access effective treatment. That is unacceptable.

I think the difference is that with HRT it increases the risk of breast cancer but the BC could have happened anyway, you can’t say with certainty it was the HRT. Whereas with these other medications they’ll cause a type of birth defect that can only be attributed to them.

https://www.elle.com/uk/life-and-culture/culture/a38411874/woman-spina-bifida-negligent-pregnancy-advice/ and a reminder of this case where someone with spina bifilar sued their mother’s GP (successfully) for negligent advice regarding folic acid.

I'd understand it more if OP was using any other form of contraception, but her husband has had a vasectomy. So unless she is unfaithful there is an absolute miniscule chance - almost zero - of her getting pregnant. The GP needs to document risks have been explained to her re pregnancy and give her the meds.

This.
It's not because of the risk of litigation. It's because the health of a unborn hypothetical child is put over the mother.
What if that women gets a blood clot due to the enforced contraception. She could sue. What if that epileptic young girl who hadn't even had a sexual experience refuses contraception and dies from a seizure because she wasn't then offered that drug. Her family could sue. Also hormone based contraception can reduce the efficiency of some epilepsy drugs. The NHS doesn't care about the litigation.

It is outrageous, woman are not human incubators and you are the person with rights not some hypothetical ubb. If you can, I would just take the prescription for the mini pill and lie that you are actually taking it.

No - in your 40s (I have been told) you are no longer allowed the contraceptive pill due to hormones and risks

Of course women are allowed the Pill in their 40s. I was on it until about a year ago and I'm 49 - and it was my decision to stop it, not my doctor's. No GP or gynaecologist has ever questioned me being on the Pill, ever.

My sister was on it until she was 52.

And what about the damage done to women who aren't allowed to take them, or who have to take contraception they don't want or need in order to access medication? As before, I think women and their decisions about their own bodies should be prioritised over theoretical unborn babies.

I don't see why any women over 40 - if family complete - would not expect her husband to get a vasectomy. My husband did exactly that (after his first and last child) as he was fully aware of the pill's side effects.

GPs are within their rights to not prescribe medication with inherent serious risks if the patient does not meet the criteria for prescription.

The OP does not meet the criteria.

It puts the GP at risk of litigation plus personal trauma if the worse were to happen.

It's also used as an anti convulsant and a mood stabiliser.

I'm a mental health nurse,and a couple of years back recently saw a female patient, in her 50s, not in a relationship and wasn't planning to have a child if she was. She had used it successfully as a mood stabiliser for years, but was now prevented from doing so because the minute risk she may get pregnant.

I don't understand how they've only recently made the link between sodium valporate and birth defects. It's been around for decades, but it's only been the last 5-10 years they've stopped prescribing it to women of child bearing age.

Because of this:

https://www.bbc.co.uk/news/health-68215937