Why are GPs so reluctant to help?

[Cosmomouse]

I have an 18 month old little boy, who took us 3 years to conceive due to polycystic ovaries.

When he was born, we decided to just carry on trying for number 2, and not go onto any contraception.

In the past 18 months I have suffered with 2 burst cysts, one of which ended up with me getting sepsis (nice!)

After a year passed with not a single period (normal for me!) I went to the GP who agreed to run the basic tests.

I waited a few months for these (basic bloods and ultrasound). I went back for the results on Monday and am absolutely amazed that they have come back absolutely normal! No cysts, hormones in line!

As the GP thought I was quite young (28) she wants me to wait longer until she refers me. Please bear in mind I still haven't had a single period despite what the blood tests say.

By the time she might consider referring me I would have been 2 years aimlessly trying with no menstrual cycle.

Is this normal or should I ask to see another GP? It's all so frustrating isn't it!

As you already have a child, you might not find quite as much help as you would hope on the NHS?? That said, it sounds like this is almost more of a health issue than a fertility issue, really! I would request to be referred to a gynae to check on the status of your pcos... The sepsis is quite troubling, expecially!

Probably normal from most gps. I find that women's health is not much of a priority in medicine generally and I reckon most of the time the doctors are just hoping the problem sorts itself!

My periods stopped for just over a year when we were TTC...I was asked to attend GP over a few months at different times of the month so they could keep doing blood tests to see if my hormones were going up/down as expected with a monthly cycle. I don't think a one off blood test tells you much but if they do a few it should say whether your body is trying to have a normal cycle or not. At the very least I'd push for some more bloods x

Did you get a copy of your blood test results? I was told mine were normal but I asked to see them and whilst the LH and FSH were technically in range, the LH was over double the FSH which can indicate a problem (in my case PCOS). I only had one small functional cyst at the time of my ultrasound too.
Best of luck!

Because funds are tight and other people have life threatening symptoms that need an ultrasound for?
I'm not being unsympathetic but you wanting another baby v a woman with ovarian cancer waiting for a scan. I think they trump you
The nhs needs more money investing in it. No one wants to do that though

It sounds bloody painful for you though and I wish you all the best

Are you breastfeeding?

Owl lady was there any need for that? Of course I'm not suggesting that I trump anybody with bloody cancer.

I know funding is tight, but I'm sure they would be better off finding out the problem as my 7 day stay in ICU was probably fairly costly!

Garden birds no I didn't breastfeed as I couldn't ☺

Sorry I didn't mean to sound such a dick :(
I feel for you honestly, I was just posting pragmatically
If you can afford it, maybe it's worth going private? Do either of you have health cover through work?

Did the GP check your prolactin levels. I didn't have any periods for years and everyone thought PCOS but my prolactin was raised and a microprolactinoma was found on my pituitary. I was treated with tablets and am now the proud owner of 2 DSs. Good luck OP.

Unfortunately, as you already have a child you won't get much help on the NHS with fertility issues. Your best option is to go private, or you could leave it a bit longer and then try a different GP. At 28, I wouldn't worry too much just yet.

Thanks all, I just wanted to get it off my chest really!

I have requested a copy of the blood test and ultrasound and as you say will look into going private. I know that the metformin worked last time so I guess I'm just frustrated we have to go through so many (costly) hoops to be prescribed it again.

Owl lady no sorry, I didn't want to come across as all entitled of course I want those with illness to be seen first! It is just annoying I guess that I just can't be prescribed the metformin as I don't particularly like costing the NHS money either. Maybe I will look at sourcing the metformin from Oxford Pharmacy.

Otherwise yes I think we will end up going private with this 😊

Not sure about prolactin! Will have a look at my blood results when I receive a copy later

As suggested above, it's all about money. They don't take women's reproductive problems seriously, it takes a lot of money to find out whats going on down there, and it's easier to write off any symptoms as inaginary. Of course this is why so many of us end up in emergency care from time to time with things left so long theyve gone badly wrong.

That's not normal at all. We are now in cycle 14 of ttc no 2 but due to my funny periods we have a referral to fertility. We had to under go basic tests although I've not had my progesterone checked. Our appointment is next week and I will be having a scan. I'm 31 so not much older.

I have pcos and didn't have a period for 10 months while TTC but once I went to the GPs she was happy to refer me to fertility clinic straight away. I expect it will be different for you TTC no 2 but NICE guidelines suggest early referral to fertility specialist if there is a known issue. I checked my GPs website and asked the receptionist who the gynae lead GP was and made sure to see them as they are usually most up to date with gynae issues. I'd try that first before going down the private route.

BTW my ultrasound and bloods were normal too. Regardless of TTC, it is important to have a few periods a year (I assume its like a good clear out!) to reduce risk of endometrial issues so perhaps your GP would consider inducing a period while waiting to be referred. I was 29 when I got referred and will be 31 by the time dc1 finally arrives so I don't think you are too young at all.

Well that's annoying - I got a copy of my blood test today and all they checked was progesterone. I thought that had to be done a week after ovulation to mean anything?

My result was 24.8 but I don't know where I am as I don't have periods.

That is interesting Sunday about your test results... I am still getting symptoms of pcos (hair, acne) although I'm not overweight something isn't right.

For PCOS they need to test LH, FSH and Testosterone levels. FSH is typically low- normal range, whereas LH and Testosterone are typically elevated. Progesterone doesn't really play much role in PCOS. If that is all they have tested you for then you need to go back and be tested again, and probably push for a referral to endocrinology or gynaecology.

The scan should show your ovaries are larger than normal and possibly have cysts (but not always). They can often look a bit like a bunch of grapes. You can have cysts without PCOS and vice versa though as well.

Other symptoms would be acne, excessive facial/body hair, mood swings/depressive episodes, weight gain and difficulty losing weight (although not always, look at VBeckham!)

It's usually a combination of those that indicate PCOS. If you think your GP doesn't really understand the condition maybe direct them towards the NHS PCOS or Verity websites.

Unfortunately you might not get any fertility help as you already have a child, although that obviously won't stop you seeking private treatment.

HTH x

Also I'm 27 and we've been TTC for over a year and just had our first fertility clinic appointment. I also have an acquaintance who knew she had non-ovulatory PCOS from a young age and had fertility treatment aged 24. You're definitely not too young.

Thank you for your replies! Yes that is what I thought r.e. blood tests. I've seen that you can get them done via pharmacy services though so I might do that and go back to the GP with solid proof!

I should at least get some help with regards to metformin/clomid. I have looked at the guidelines for my area and although I wouldn't be eligible for IUI/IVF if it came to that, anything up to that I meet the criteria for.

I'm slightly less stressed about it now. I know we will get there eventually, it just seems an uphill struggle sometimes.

susu best of luck! What happened at your first appointment?

I'm slightly hesitant to suggest this but I found that even when the doctor tried to help with my pcos they did stuff that didn't help eg putting me on the pill. Western medicine is pretty limited when it comes to women's health. The thing that worked for me was taking charge of it myself and totally changing my diet and lifestyle (drastic I know!!) - I also got some help from a naturopath (was living abroad and they were virtually trained as doctors), chiropractor and acupuncturist but the main thing was getting educated about my diet - it only took a few months before I got regular cycles (after years and years of a period every 3-6 months) and I've never gone back.
I'm always hesitant to say what I did because it all sounds so hippyish but it's worked when nothing from the doctor helped and they were really very dismissive from the outset ("you have pcos - nothing we can do about it" attitude). I'm now on my fourth child, all conceived within a few months of starting ttc.

Hi there! It's so frustrating isn't it. I understand that they have to budget and treat the most serious cases, but it's ridiculous that the NHS wastes money testing for the wrong things at the wrong time of the month. Like you say progesterone should be tested after ovulation and you really need full blood tests to be done. With PCOS it's important to check the ratio of LH to FSH, not just the values themselves.

I would also press to have your thyroid levels checked, especially if you have any symptoms of it being under active (eg tiredness, feeling cold). PCOS and under active thyroid are often linked and an untreated thyroid problem can also make getting pregnant difficult.

If you want to take matters into your own hands, the PCOS Diva website is really helpful - there is some evidence that a particular low GI diet helps with anovulator PCOS (even if you don't have weight problems). Inositol is also supposed to help. Normally I wouldn't recommend self medicating but from the research I did there didn't seem to be any risk in taking it.

Posted too soon....

Also maybe look into acupuncture and Chinese medicine which I think really helps regulating cycle problems (you need to find somebody specialising in fertility). I have PCOS and only had 3 or 4 periods a year but with acupuncture and TCM I started ovulating.

Hope that helps!