DD going on the pill - medical history?

[sinningsaint]

DD has decided to go on the pill and has an appointment at the docs next week. She will be going on her own but was just wondering what questions she will be asked about family medical history and what I need to clue her up on. Am I right in thinking breast/cervical cancer, heart attacks and strokes? Also is there anything else other than checking blood pressure and weight I should warn her about? Any info would be appreciated really, i've not been for this sort of thing in yonks!

Those are the main questions. I would also discuss STDs and the importance of condom use to prevent infection. How old is she?

She is 16, isn't sexually active yet but going on to try and stop painful periods and so that she can find the right brand before she does become active so isn't messing around changing it and putting it's effectiveness a risk. We have talked about safety but I think so much is drummed in to them at school nowadays about STI's and STD's she knows more than me!

Has she had painful periods for a long time?. The pill could help but it may well not get rid of any underlying problem re pain once she comes off it. It may just mask the symptoms.

Would she actually consider seeing a gynae?.

She has always had painful periods but they aren't excruciating just an inconvenience and something that has been a deciding factor of what contraception to go on. Appointments with the gynae in our area are very few and far between and she would be looking at at least 3 months wait if not more to see her which seems stupid when she can see the gp within 4 weeks, gynae is also based what would be a long bus journey away for her including changes compared to the gp at the end of the road.

sinningsaint,

The problem is that such problems are often outside a GPs remit; they are generalists after all. She may well be advised to book an appointment as well with a gynaecologist.

The pill will help but it could also mask any endometriosis if this is indeed there. Any endo would return if and when she came off the pill for whatever reason.

If she does not do so already I would suggest that she keeps a daily pain and symptom diary noting sites of pain and duration of it.

As someone who suffered from painful periods for many years (and there is always a cause) I would not want to see other women suffer as I did hence the suggestion to also see a gynae. Could you yourself not take her to see such a person?.

For a couple of months last year she kept a symptom diary which on going over with the gp, who had previously worked as a gynae, put it down to hormones. As a sufferer from endo I can also see DD is in no where near as much pain as I have been when it was at it's best. I could take her to appointments but being 16 she won't allow me to actually go in with her and it is not viable for me to take time out of work (I am a teacher) to drive her to appointments which are only between 9am-1pm. She also has a boyfriend and although I have stated she isn't currently sexually active, understandably I don't want her to have to wait months to be put on a pill that in the end may not be right and mean she then has to wait another 3 months to see the gynae again to get it changed!

One very important aspect of family history when starting hormonal methods is deep vein thrombosis or pulmonary embolism. So try to find out whether any close family members have had this, and at what age (usually would be treated with warfarin tablets for several months if it was a confirmed DVT/PE). Also, your daughter should be asked about any history of migraine headaches in herself - so it would be helpful if she thought about any recurrent headaches she's had and accompanying symptoms such as zig zag lines or flashing lights on one side of her vision etc.
Having said that, even if the combined pill is contraindicated by any of the above, she may still be suitable for progestogen-only methods like the mini pill.

Not what will be asked at Dr's as others have already covered it but something for you to make her aware of - After starting it if she gets any migraines (especially those with visual disturbance, numbness etc) then straight back to GP.

they want to know about 'first line' relatives - parents, siblings, uncles, aunts, grandparents.

the relevant conditions are stroke, heart attack, migraine, DVT.

final obvious; while smoking is clearly unintelligent, smoking combined with the pill is Darwin-award stuff. If she does smoke she needs to be honest. And give it up.

and yes, if she does get a first migraine or any sign of a blood clot once on the pill, get quick advice. Very very rare to have these problems.