GP - treatment offers for period/ovulation pain 16 yo

[DoinItForTheKids]

Hi

And by GP I mean General Practitioner, not grandparents!

My DD has two ills each month one being her period which can be really painful, and the other is ovulation pain in the middle of the cycle - enough to double her up at its worst. She has lost numerous school days from either one and we've certainly waited a considerable time to see if it would all calm down - it hasn't.

We have a GP appointment on Monday to discuss this whole topic and I wanted advice from others who've had DDs with this, to find out how your request for help was taken by the GP, what treatment/solutions were offered, and how well did they work?

Be helpful to see how this issue was addressed with others and might give me a bit of a steer to offer ideas to DD about which option(s) offered she might want to research ahead of the appointment.

Thank you.

I don’t have a DD, but I am in the same position as your DD- it took me nearly 4 years to finally see a paediatric gynaecologist, and they still seem to have no clue what’s going on!

I hope you don’t think I’m being patronising, but this is going to be a long, emotional journey, and at some points (especially for your DD) it will feel like there’s no point in carrying on, trying to get a solution to this problem. When this happens (hopefully it won’t, but it did to me, and I sank into a slight depressive phase) please encourage her to carry on. There will be a solution at the end of it, even if it seems impossible right now. I would also encourage her to remember, she knows her body the best, and if she feels something is not normal, the likelihood is, it’s not normal. She will get a lot of people saying “this is normal, it’ll settle down, don’t worry about it” but she will have to fight her corner. I mean, I’m 15, in Y11, and I think the same year as your daughter, and it took me collapsing in A&E for a doctor to even say it might not be normal.

I’d also say, if she feels comfortable, encourage her to share her issues with supportive friends. I’ve had this issue since 2014 (as you can probably tell by the amount of times I’ve said it!) and only late last year did I become comfortable with telling some close friends about it. I actually found a couple of my friends also have had complaints about their periods, and they’ve been treated in a similar way to me, and it’s quite cathartic to have a bit of a rant about it with people who get it.

(Also, some of the attitudes other people on this thread experienced in previous years are most definitely prevalent today. I was told this Tuesday by my gynaecologist that having a baby will solve my issues!)

Interesting, interesting and thanks to all for sharing their experiences. I honestly think that anyone offering symptom control only and not explaining that there could be an underlying condition that could affect you in all these ways and could only be resolved with surgery, is abhorrent and unprofessional, and unacceptable. When giving treatment if appears 'informed consent' doesn't apply (?) like it does when undergoing surgery. Maybe if women were asked, you can have the pill which may help for the moment but it might only work for 6 months and there's a chance that there is an underlying problem such as endometriosis which could cause painful sex, ongoing period and ovulation problems, fertility problems, problems conceiving and possible risk of miscarriage and giving you the pill will only mask those symptoms if they are caused by the example I gave you, do you still want to take my offer of the pill? That would be an informed decision.

But it's like a game (one that's not funny or enjoyable) where the woman is told to try this to try that to do this to do that (to have a baby to solve the problem - that's fucking useful to a 14 year old!!!) and essentially, to just suffer, stumbling around in the dark so to speak, from one 'treatment' to another.

Thankfully, DDs symptoms are by comparison to your guys tales, very mild on the scale. I'm not saying that it doesn't mean she hasn't got endometriosis and I'm grateful to the head wobble on this possibility (among all the things it could be) so at the very least at this point, I will tell her all the facts so she doesn't think she's been 'cured'.

I think one of the worst things about this is that actually, the time to act is whilst the person is young, before they start trying to have a baby, before they do have a baby! Not bloody years afterwards.

Then at some point if she wants to take it further we will - and if she can't get the referral she needs thru the NHS, we'll scrimp and save until she can get it privately if necessary.

So sorry to hear about this litany of inaction and the effects it has had on people - being in regular or constant pain is no way to live.

I think the core thing aside from the ingrained sexism which appears to show no sign of abating. The existence of pain is not a symptom - of nothing - is it?! It's a symptom of something. Yes, obviously, there's going to be some pain with menstruation and I don't think any of us are divvy enough to think that it would be totally pain-free - the lining of the uterus is dropping away, there are some open blood vessels involved that also bleed, that's not going to be sensationless. But to say suffering in pain every month of your life or every day is 'normal' is quite obviously utterly stupid. To expect one half of society to have to tolerate that is appalling.

Quick suggestion from me - if the pill does control her symptoms enough that you decide not to pursue any further at this stage, please encourage her / suggest to her that it’s wise to stay on the pill / other hormonal contraceptive until either her symptoms become unmanageable even with that, or she wants to try for a baby. If it is endometriosis, each period causes more internal damage so controlling the cycle means less damage. If the pain is still severe, that could suggest endo deposits internally bleeding and therefore causing scar tissue. I honestly believe that I owe my fertility to having been on the pill from 13 until I was diagnosed at 22, then a variety of other treatments after that. I’ve barely had an unregulated cycle since I was 13 years old. For the six months I was off the pill before I got pregnant, there was more damage in those six months than the previous decade.

But to say suffering in pain every month of your life or every day is 'normal' is quite obviously utterly stupid. To expect one half of society to have to tolerate that is appalling.

This is what I was told, that period pain is normal. I’ve been in A&E with it before. My cesarean and miscarriages have been less painful physically than my teenage periods.

I wish I’d pushed them to treat it because I worry I’ve fucked up my fertility by leaving it. It’s disgusting that young women are left to suffer and damage their health.

I agree thecats.

From a feminism point of view, I get focusing on pay differences and all that. But I think that our healthcare should be absolutely a fundamental right, and that should include not being fobbed off with the oh its womens problems. All we can do I suppose is tell our daughters that pain outside of feeling a bit crap and normal milder pains you'd associate with your body having a period are NOT normal and ARE a sign of underlying problems

Sadly as we can see our whole system of GP referrals in this particular area is designed to support a fobbing off culture so that many women probably never get diagnosed in their entire lifetime. I can't see how that can be right.

It shouldn't be down to luck that you happen to land with a GP who's pro women's health!

THIS is feminism, right here. When you're not listened to, that's the core problem.

OP I can remember feeling relieved I had a son because he wouldn’t experience the painful periods I, my mother, her mother and her sisters did.

Op love your post at 1100, I also think the coil is being pushed and I hate that, I know loads of women the coil has done irreparable harm to, there's several threads on here about this too AND lots of women who have even relatively minor issues with the coil meet lots of obstruction when they want it to be removed - again also lots of threads on here about that.

When dd was in her first serious relationship last summer and was discussing contraception with me I must admit I said to her - her choice but I'd strongly advise against the coil. She said to me she'd already decided that as she had friends and friends Mother's/sisters etc say about the problems they've had with it.

The average time until diagnosis for endo is 7.5 YEARS it used to be 12 when I was first diagnosed 18 years ago.

3 YEARS for pcos, about same for fibroids.

In addition even if GP does refer to a gynae you could be waiting 4-6 months for that appointment anyway.

Something I wasn't able to find but would be interesting to know - how long from first appointment with GP until a GP refers to a gynae?

"If it was a male internal problem it would not happen."
Damn straight!

"they’re told that periods hurt and that’s how it is." Yep

"and if she feels something is not normal, the likelihood is, it’s not normal." Definitely. I KNEW something wasn't right, so much so that by the time I was 16/17 I already had it in my head that I wanted to ttc no later than age 25, I just knew I'd have problems. I had my first mc aged almost 19. No surgery necessary so was again basically dismissed. When I was early in my relationship with my ex I explained it all to him. In the first year he had to go with me to a&e when I collapsed due to the pain while out. No ultrasound, the only interest they even had in gynae side was to do a pregnancy test, they were satisfied it wasn't another mc, although they didn't do an ultrasound or any other testing. I was given painkillers, anti-emetic (pain was bad enough I was also vomiting), told it was probably normal menstrual cramps setting off ibs and sent home.

We married at 24, started ttc at 25, I fell pregnant. I then mc for second time, was admitted as the non uk Drs correctly assessed it wasn't a "normal" mc, turns out it was twins and one was ectopic. Surgical and then medical management, surgeon saw extensive endo that she removed as much as she could. I was then later admitted for further surgery to remove more and was on medication for a year to reduce the smaller amounts of endo that couldn't be removed surgically. Had regular monitoring by a gynae. Then just as I was finishing those meds ex was sent away for work, then he got sick soon after coming home and until we knew what was wrong we were advised to avoid ttc. (Turned out to be nothing that was a problem there but he was sick for months).

Consequence was finally got pregnant with dd, was closely monitored thank goodness as it was a complex pregnancy.

I can't help but wonder if I'd had faster referral, faster diagnosis and treatment if dds pregnancy and birth would've gone better.

"My cesarean and miscarriages have been less painful physically than my teenage periods." Yep, both mc and 27 hour labour without pain meds prior to emcs were all LESS painful than my periods. Was up and walking 12 hours after section - nurses were shocked, again less painful than my periods.

I've an aunt also has endo (but we're not close so I didn't learn this till years later) she'd had 9 mc in the course of trying to have my 2 cousins. How she coped with that emotionally I have no idea.

I’m sure my sister has it but she doesn’t want kids and has just tolerated it for years.

After I was diagnosed I got a copy of my hospital notes, and every A&E visit it had something written like: differential diagnosis - ovarian cyst or psychosomatic pain. Not one mention of endo. You’d think it was rare. It was missed on my first lap, found out later I was on the operating table for less than 10 minutes and there weren’t even enough incisions to examine internally properly.

Was up and walking 12 hours after section - nurses were shocked, again less painful than my periods.

Yep the next day after my cesarean I was back to normal. After my ERPCs I’ve been literally jumping off the bed walking home, nurses don’t get it. It’s because the “pain” is nothing compared to periods

Tammy that's fucking outrageous! Op is so right, it's very much a feminist issue.

Not just because it's gynae but because were dismissed, it's put down to us "exaggerating" or "having a low pain threshold" (because women can't do pain - even though that is what we deal with all our adult lives basically)

See how keen they are to revert to diagnosing some kind of mental insufficiency - that mental insufficiency must be the only answer?! This is what used to happen in terms of how mentally deficient women were viewed as with regard to being unable to make voting choices, or be involved in business - that was in Victorian times! I'd like to say a lot has changed but fundamentally, a lot of things haven't changed at all have they.

Yep! It’s called “hysteria” for a reason (I was in my mid 20s before I realised the etymology of that word)

When my first lap was “clear”, a doctor came to my bedside and told me that they had thoroughly examined me and my insides were completely physically normal, then asked whether I had ever experienced sexual abuse as imaginary pelvic pain is a common symptom

(Err yes actually - like 1 in 5 women, and 1 in 10 women have endo so you do the maths)

I literally left that hospital full of shame, suffered on for another 18 months and on my fifth hospital admission for Pain in 6 months a gynae decided to operate. She said “if you’ve had a lap, where are your scars?” - I said “I only had two, one in my belly button, one tiny hole for the gas”. She explained that meant they’d literally put a camera in, looked at what was immediately visible and then given up.

Years later when I found a specialist he gave me a DVD of the surgery he did - camera goes in, all looks normal, uses some instruments to move things around, and voila, my entire abdomen covered with what looked like orange blisters (not a typical presentation which obviously didn’t help).

I try not to be too angry about it since it serves no purpose but I am angry. I sent my husband to the GP with a comparatively minor complaint and after one consultation he had a referral and two prescriptions, one for the same painkillers it took me 10 years to obtain. It’s infuriating.

It's madness Tammy. That surgeon should be bloody sued.

Tammy that makes me so angry.

Yes I think there is still huge sexism in healthcare. Perpetrated by women as well as male Drs.

It's outrageous.

Yea we're all hysterical women who are imagining severe pain, blood loss, migraine etc

Sorry for butting in like that but I have a concern of my own if any of you might encounter, I’m a bit stuck and don’t really want to waste nhs’s time.
After aprox 10 years on the pill( without periods) I’ve been sterilised . Since then (nearly 4 years) ovulation period is an absolute nightmare to the point I am unable to sit due to pain . For about two months now that hasn’t happened by my breasts are getting so hard and hot to the point I cannot put my bra on , it starts about a week before period and lasts pretty much until next ovulation starts so is continuous .
Now I’ve instpected my breasts for lumps, changes etc and everything looks fine but although I like the feeling of having bigger boobs I cannot take the pain anymore!
Is this something you have encountered? I’m thinking it might be mastitis?

@cmimi83 you need to see your GP, not rely on advice from here. If your breasts have got larger you may need a referral to a breast clinic.

Yes I should try to get an appointment, I’ll wait until my period goes to see if any change. I start to regret this sterilisation thing with all this issues I never had before .

Definitely please get seen cmimi.

Update from our GP visit today:
The GP was lovely (she is really lovely) and spoke directly to DD, took a proper history etc, explained the options (which were threefold - mefanamic acid, whatever the drug's called that can defer a period, and the pill.

After full explanation of all the pro's and con's, DD decided she would go with the mefanamic acid and see how she got on with that as she advised me that the ovulation pain seemed to have eased off a bit so she wanted to concentrate more on sorting out the period pain.

She also pre-weighed and blood pressured her so that if she wanted to ask for the period deferment pills in case she knew a period was going to hit in the middle of say, a sports exam where feeling heavy and in pain wouldn't be very helpful. She advised we could just phone her if we wanted that, no need to come in for another appointment.

So, we can see how we go on that, we're still aware that it may well/probably is an underlying issue but for the moment we will give this a go. I talked to DD about the fact it could result in painful sex, trouble TTC, miscarriages and that there was likely an underlying reason, but let's do this for a bit and see how we go.

Glad it went well and it does sound like you've an understanding GP there which makes a big difference

This sounds like endometriosis. Yes the pill will stop in the short term but it can be worse and lead to build up.

If you're daughter is in serious serious pain it may be worth trying to get an official endo diagnosis but it will take a lot of pushing!

Cheers Graphista.

I know it might be endo (already talked to DD about it), so I hear that loud and clear. I also understand if that's the case it's possibly masking - any pain relief is masking, thingy wotsit acid is masking, hot water bottle is masking.... But, rightly or wrongly, there is a process to go through and this is step 1 of that process.

I am happy with where we are at the end of today but if anything needs pushing in the future, believe me, it'll be pushed VERY hard from my end!

She's not in 'serious' pain (thank goodness), she's a lot better than many of the personal accounts given on here so I think this is an entirely acceptable first step. Rest assured, I will not be fobbed off if either of us feels it needs to be addressed in a more robust fashion.

Glad to hear the appointment went well OP, it really does sound like you have a great GP on your side!

The option of norethisterone and the pill are very helpful, and it’s good the GP had informed you and your DD about these. Whilst I can see you may not want your daughter to take the pill, or any form of synthetic hormone, please please please give your daughter an objective view on them, so she can make the best decision for her health. Again, I really don’t mean to sound patronising, but for over a year my mum demonised the pill, saying anything is better than taking it, and no one will marry me if I’m on it, and it’ll give the wrong impression to other people, blah blah blah, but now that I have no choice but to use hormonal contraception, I feel incredibly guilty at the thought. It’s also delayed my journey to a diagnosis I believe, as if I had started it when they first recommended it to me, rather than waiting 18 months, I would probably be closer to a diagnosis than I am now.