Gynaecology Appointment Today - PCOS

[Rockhopper81]

Hi all,

I had my gynaecologist appointment today for PCOS - I'm going to be using a known donor for insemination, I don't have regular periods (I've never had a positive OPK either - had a thread about that the other day - now using OvuSense), I have classic facial hair of PCOS.

It wasn't at all useful and I'm just so sad at the moment.

My GP was shocked I'd never had any 'treatment' for the PCOS (when it was diagnosed 10yrs ago I was quite literally told I had it by the woman who did my scan and that was it - the GP didn't want to know as I wasn't actively trying to have a baby).

The GP asked if I'd ever been prescribed Metformin, which I haven't.

The registrar I saw this afternoon (an hour past my appointment time - I know it can't be helped, but it didn't improve my mood any when it was a useless appointment), who couldn't have cared less about the fertility side.

She just told me to lose weight to help. I said I'd been trying and it was proving difficult. She just said to keep trying. I mentioned Metformin - nothing. I haven't not got pregnant yet. Which is true, I get that. 6 periods a year is fine apparently, the fact that they can be 23 days apart or 67 days apart is irrelevant.

Essentially, because I haven't failed at getting pregnant, they won't even look at the fertility side of things. I explained about the donor thing, the months of negative OPKs, just wanting a clearer view of what was going on - nope, not interested. I haven't proven there's a fertility issue.

I paid to have a scan privately a few weeks ago - showed cysts on both ovaries. Took the report and pictures to show, along with the blood work I'd had done on day 3 of my cycle (which she should have had, but didn't, and didn't want to keep a copy of) - not interested.

Conferred with her superior (the consultant) - yep, lose weight. We'll refer you to a dietician.

I'm just so sad about it all. I know I need to lose weight - it's not like I haven't been bloody trying - but once again the doctor hasn't seen a person, they've seen a fat person.

I know I'm not entitled to help getting pregnant on the NHS, and I accept that, but my GP said I could be seen on the NHS and probably prescribed Metformin.

I'm just so angry and sad about it all and wanted to vent I guess.

Congratulations if you got to the end of my essay!

Do you know what your BMI is? The doctors might be willing to help but... things like Clomid that are prescribed to help with ovulation are pretty problematic in obese patients (BMI over 30). I think that goes for a lot of other meds too. If your BMI over over 30, then it would really improve your health and chances of even becoming pregnant if you lost weight. In addition, pregnancy in obesity is very dangerous with high risk of complications, e.g. gestational diabetes or preeclampsia...

I know losing weight isn't easy as it requires improving on bad habits that people have had for years... However, it's very helpful that they have referred to you to a dietician. You could also try Slimming World or Weight Watchers etc. Once you get going, you could lose 0.5-1kg/week and presumably reach a better weight within a few months.

To be fair, I didn't go expecting them to prescribe Clomid, not at all. I suspect I did go expecting them to prescribe Metformin - it's been useful with some people with PCOS in helping them lose weight, due to insulin resistance that is not uncommon with the disorder. I am trying to lose weight - I made that perfectly clear, several times - and it is proving very, very difficult.

I did not expect to have not had my blood tests looked at beforehand and then, when the registrar did look at them, to have them disregarded. She didn't even ask what day of my cycle the blood was taken on, when I specifically went on day 3 as I knew that was a good time to go. She wouldn't have known that from looking at the results I took, it's not on there anywhere.

I appreciate your advice, but if losing weight was purely as simple as 'improving on bad habits', I'd have lost a hell of a lot more weight than I have by now.

My point is that, when they saw I was overweight, they didn't want to know anything else. I guess I made the assumption that because my GP - the only medical person ever - actually wanted to help with my PCOS, the gynaecology department might want to as well.

I'm aware I'm feeling sorry for myself, but I think I'm allowed to feel sad at the moment - I know I'm struggling to lose weight, but I thought I was doing everything else 'right'. I've been doing OPKs for months, with no positive. I've bought OvuSense and will just have to trust that it's accurate now. I paid for a scan privately so that I could go to the appointment armed with as much information as possible, and to not have to have it done through the NHS. I asked for the blood test to check my hormone levels and went on the appropriate day of my cycle. I thought I was doing the right thing.

I'm sorry you had a rubbish appointment. I'm in a similar situation Pcos and trying to conceive. I already have a DS and so my GP isn't able to refer me on anywhere under local guidelines but was happy to prescribe metformin to support my weight loss and fingers crossed for a fertility benefit. Would your GP prescribe metofrimin? Could you go back there if they were supportive? I've also had a weight loss referral as I've been trying to lose for ages and haven't had any success so far it's been a complete waste of time as they don't believe I'm telling the truth about eating/exercise and say that I'd be losing weight, they just don't get Pcos, hope you have more luck.

I was just wondering the same - if you've got insulin resistance, wouldn't GP help you manage regarless of fertility concerns?

I've got PCOS too and understand exactly where you're coming from. I was diagnosed years ago but told come back if you can't get pregnant. I also really struggle to lose weight, I've done ww, slimming world etc and find that I lose 10 pounds easily and then it plateaus even when I'm still being super good, that makes me lose heart and then your back into a vicious circle! I've had metformin and if I'm honest I don't think it made much of a difference.
We got referred for infertility treatment and again I couldn't start till I'd hit a certain weight. I tried really hard and lost quite a bit but once again it stuck about half a stone away from where I needed to be. Eventually we decided not to continue on the IVF route, not just because of the weight, were not getting any younger and the likelihood of failed attempts for us made me wonder if it was worth putting ourselves through it. Fast forward a couple of years and we've now got a beautiful little one who we adopted a year ago and we couldn't be happier.
Sorry for the long post but just wanted to say I've been there and understand your frustration. Keep positive and I'm sure everything will work out for you in the end.

OP, have you looked for the PCOS support thread on here? I found it invaluable when I was dealing with useless drs etc.

Of course you're allowed to feel frustrated and upset with an appointment that didn't give you the answers that you need.

In my experience, weight is a massive factor but in true catch 22 style, being overweight makes the symptoms worse and it harder to conceive, but the condition itself makes it harder to lose weight. A low GI diet helped me (although it's still an uphill battle).

Metformin may have helped but access to it seems to defend on where in the country you are unfortunately.
I would do some real research into what it does and go back to your GP to try again.

I learned on the support thread that sometimes if you go to a doctor armed with information and an idea of what you want the outcome to be, it's easier to fight through and be seen as an actual individual person.

Another bit of info (and I apologise as this is long) - OPKs don't really help if you have PCOS. Several people on the thread when I was on it were upset with their negative OPKs in the cycle they got pregnant. Yet another delightful effect of the condition - your hormones don't act like a regular persons and they don't react to the tests as they should either.

It's a horrible thing to deal with. My best advice would be to read, research, join the thread on here, look for other specific support forums and gather as much information as you can. Then try and go back to your GP or consultant.

I've got PCOS, metformin is suggested for those with insulin resistance issues but did nothing for me, I had to really fight for it. Had 6 cycles of clomid an ovulation inducing agent, I ovulated but didn't get pregnant and needed ivf in the end. There's many manifestations of PCOS, I have 3 periods a year on average, moderate hair issues if not on the pill (Yasmin) and weigh 7 stone. I've known people with it who are overweight who have not had issues with pregnancy. Don't panic yet. By the way OPKs are inaccurate in PCOS because of the hormone imbalance. I wasted a lot of money on them before finding that out!

Sorry, just seen it was mentioned above about the OPK!

I have PCOS and had similar treatment from doctors - go away, lose weight. However both times I conceived it was after losing around a stone, so there may be something in it, though they could be more sensitive about it. I also found that metformin did nothing for me as I didn't understand that you need to watch your diet carefully in conjunction with taking it.

The only diets that have ever worked for me have been low carb ones. Don't go to SW or WW as the kind of diet they advocate are not helpful for PCOS. If you want to know more come and check out the low carb bootcamp thread, several of us have pcos and are amazed at how good we feel going low carb.

Thank you all for your replies - I think I am going to go back to the GP and see what she says.

It's totally a catch-22 situation with needing to lose weight to improve the PCOS, but the PCOS makes it hard to lose weight. Aargh!

I've just read that the OPKs aren't very reliable for PCOS, so I'm going to ditch them I think - they're not helping practically or emotionally I don't think.

Griseldachop - I'm exactly the same, the first 10lbs comes off, then nothing. It's disheartening when you know you're 'being good' and it's still not helping.

Mummywuks - I have very noticeable facial hair if I don't 'deal' with it too.

I think I probably am panicking slightly too that I'm 36 now and 'not getting any younger'!

I'll look that thread up IsItI, thank you.

Just frustrated and sad at the moment - I'm sure when I've got a plan tomorrow I'll feel a lot better about things. Thanks for all your support.