Gynae Appt - what should I be asking?

[MNTotoro]

I have a history of prolonged, heavy and paiful periods. The periods can last 3 weeks, I have a break of a few days and they start again.

I have had 3 years of to'ing and fro'ing with the GP and various blood tests, smear tests, an internal exam, 2 contraceptive pills (both sent me loopy), and now progesterone tablets (which are working, yay)

The GP isnt sure if I should stay on the hormone tablets as I am only 35 and could have another 20 yrs of this .

I am also having hot flushes, and night sweats. GP says I am not menopausal, and bllods show everything is fine. But clearky it isnt.

I guess I want to know the cause of my problems, and I need a long-term solution.

I'm a bit scared of seeing a consultant in case they think I'm wasting their time

Gawd, I cant spell today

Dunno, but am watching with interest. I have terrible heavy, painful periods passing big clots. I haven't been to the GP about this as I know he'll say for me to try the pill. I really don't want to, I got sterilised in my late 20s as I hated the pill's side effects so much. And I'm worried that I'll be pushed into that. I know that I have endometriosis as I had a laporoscopy for something else 8 years ago and they found it then. But at the time my periods weren't heavy or painful.

Could you ask for a laporoscopy to see if you have endo?

I don't think the consultant will think you're wasting his/her time. As you are having problem periods, they will probably suggest a laporoscopy to investigate further.

I had heavy prolonged periods earlier this year and eventually had endometrial ablation. (My choice), but the gynae did a laproscopy at the same time. However I'm 42 and have had children. Endometrial Ablation may not be the best choice for you.

It's definitely worth having a chat to find out your best options.

And you might like to ask if a trans-vaginal scan is indicated - to look for fibroids and ovarian cysts (including "chocolate cysts" - ones with endometrial tissue).

Vivalebeaver - it is awful isnt it.

Thanks orangeflutie - I have 2 kids and although I'm not planning more I'm not 100% which I think would rule out the EA.

onimolap - I had thought about fibroids. My grandmother had them and ended up having a hysterectomy in her 40s. My GP did a quick internal and said he could feel anything sugnificant though.

MNTotoro,, Don't worry for a single moment that your wasting consultants' time.. It's their job!

I have had a similar problem starting 3 years ago,..With my first consultant had ultrasound,and Hysteroscopy, followed by Cryocautery on Cervix to get rid of a bit of endo.. 6 months later no change, went back to GP and asked for 2nd opinion- New consultant found 2 pea sizes fibroids,(they must have grown pretty fast to have been missed first time),He wanted to try a 'Mirena" coil rather then progesterone tablets which releases progesterone directly into the uterus.. I decided against that after taking further advice as i have a history of PID..He then wanted to try a D+C,or possible Hysterectomy!
Cheeky Bugger!! I insisted on endometrial sampling first, which actually came back as fine!I left it at that,sick to death of it all-Now 2 years down the line,i now have menopausal symptoms,(but i am a lot older then you)and fastly vanishing periods(which is a relief!)and hopefully shrinking fibroids... Did your bloods come back fine re. Thyroid??

My advice would be when you see consultant; Ask questions- if you don't understand, Be a pain in the backside if need be..I got my consultant to draw diagrams till i really understood.

If you're not happy, say so, ask if there are any alternative solutions.

Write down any other details/symptoms that you think might be connected, to give them a clue,Or any key words he/she says so that you can look them up later, it's easy to forget stuff when you're in there!

Good luck!..Would be interested to see how it all concludes, but it may take a while!

You are absolutely not wasting their time. I am having a hysteroscopy and mirena fitted under GA in 2 weeks because of very heavy periods (can get thru a super plus tampon in about 2 hours)

My gynae has been so wonderful, hes so sympathetic about everything and is hoping that this will sort my problems.

Where are you in the UK?

My recommendation would be write down all the details of your period history and be ready to make sure they actually listen. I have just, after 18 years of going to the GP about problems, been diagnosed with PCOS and only after 6 months of gynae appts where they have faffed and fiddled about. Penultimate one being 'oh no we can't say you have PCOS because you haven't had xyz blood tests yet'. Went for xyz blood tests and what do you know, it confirmed the PCOS that I have spent years saying I think I have and was told a few months ago yes it was. I'd also suggest that if you end up having to go for further appts that you ask to always see the same person.

Hi MNTotoro,

I agree fully with all that mychildrenarebarmy has written. Jellykat's counsel as well is also bang on.

You are not wasting their time; such problems can and do impact badly on day to day living.

As someone who waited over a decade to get her endo diagnosis you are not wasting their time!. You will need to be persistant in order to get answers, it is all too easy to be fobbed off!.

Wow, thanks everyone.

Lots to think about.

The bloods showed that my thyroid is ok.

I could possibly list symptoms that would link it to perimenopause tbh - extra weight around middle, slightly more facial hair, slightly receding hair line. But I dont know if I'm trying to make the symptoms fit tbh.

I do know that the progesterone tablets have completely sorted my cycle, reduced blood loss and pain. Would that indicate it is just my hormones, do you think?

Hiya MNT!
If bloods were ok, then it really does seem to indicate perimenopause stuff, with the hot flushes etc.. But you're only 35!,and the bodies' temperature does increase when you're menstruating..AND periods start winding down, off and on with perimenopause..

Still reckon Fibroids could be a possibility , Working on the theory that they are oestrogen fed, and your increase in progesterone , seems to be reducing the blood flow.. but then progesterone helps with menopause..

Guess a scan will soon sort it out!
I'm dying to know now! ,When is your Gynae appt??.. God, The things we women have to go through!!

Any bleeding is down to hormones by its very nature.

Your best bet is prob the Mirena, rather than tablets if that is what helps and you are sure you don't want an ablation.

• and you don't have to have a GA to have it fitted.

I know plenty who have had it done without, and I had a hysteroscopy last week without any GA or pain relief.

Just don't be rushed into anything- you can always say you want to think about options and go back. Ask as many questions as you want; that's what they are paid for.

Fibroids are really common- 50% of women have them. I have one, but had no idea until I had an internal for other reasons. It is evidently small. They are not dangerous; all they do is increase the surface area of the uterus so that you lose more blood.

You can have fibroids removed and nowadays doing a hysterectomy for heavy periods is really out of date- there are so many other ways to stop bleeding.

Thanks All.

Jellykat - you'll have a few weeks to wait for an update :)

MNTotoro .. Good luck!..Guess this thread will be in the 'older threads' bit by then,there is one isn't there? - Will return to it to see!

Saw the consultant today.
He did an internal exam and suggested that as the progesterone tablets have worked my best bet is the Mirena coil. He wouldnt recommend an Endometrial Ablation because of my age.

He also said I have a cervical erosion, but as I'm not bleeding after sex or in between preiods he wasnt unduly worried about it.

I felt a bit railroaded tbh. Now I have to go back to my GP and get the Mirena fitted. I just hope it works properly...

Sadly it does seem that you've not much choice at the moment but at least you've seen the consultant and found out your options.

It's worth giving the Mirena a try as your body responded to the progesterone tablets, and it will hopefully give you a break from heavy bleeding. It didn't work for me but my body didn't like the progesterone tablets either!

You need to give the Mirena at least six months to settle down, but if you're not happy after this time it's easy to get it removed.

Just received a copy of the letter the gynae sent to my GP and it mentions the cervical erosion, and all the mirena advice. It also says I have a uterus at 8 weeks size!! Any idea what that means?

I could only guess at that one MN. My advice would be to ring your consultant and ask him/her to explain. From someone who has had ovarian surgery recently; I think sometimes there are assumptions that we will understand medical terms. Hopefully your consultant is approachable and will be all to happy to help you understand the diagnosis and the best ways that you can contribute to and manage your treatment. Good Luck! Joh

Thanks JohFlow.

There is no contact number on the letter and I really didn't find him that approachable.

I had a nurse appt today and asked her about it. She said the consultant should have explained to me, and done a scan to find out why. She wants me to go back to my GP and dicsuss it with him.

I am so tired of all of this :(

Update - GP told me not to worry about the size issue. He said it was for reference only so they could compare in future, and it wasnt abnormal.

I had the Mirena put in in February and so far so good!