Get GP to take period pains seriously

[ljcudd]

Just after some advice before I call the GP next week to probably get fobbed off...

I gave birth to my little girl in May 2020, and since then my periods have been horrendously painful. I had an emergency c section due to sepsis in labour and failure to progress. Not sure if related but due to her position they had to "man handle" my bowels more than usual and as a result my bowels paralysed and I had to have an ng tube fitted to drain my stomach to stop me vomitting faecal matter. May or may not be relevant for reasons later.

Today I came on, and this has been the worst of the lot since giving birth although they've all gotten progressively worse month to month. All I've been able to do today is curl up in a ball or lie in a scorching hot bath (literally spent 4 hours in one today draining g and topping up with hot water when needed). Literally feels like it did in labour except no waves, just constant pain. Can't even tolerate wearing clothes as anything across my belly is making the pain worse. Dug out my labour nightie to wear since it never ended up being used 😂 I've taken the highest dose possible of naproxen and highest dose of co codamol and it's not even made a dent in the pain although helped me sleep an hour. I take these painkillers for my joint disorder and they work a treat usually. Been feeling shakey and light headed with the pain (even pre the meds).

Also had diarrhoea which I know is fairly normal but I've also noticed increased pain when passing bowel movements in the week leading up to my period (like a stabbing pain in my pelvic area) and also when urinating. No UTI. Think some paranoia there's lasting damage to my bowels or maybe endo involving the bowels?

I can't keep going on like this. I can't function at all and trying to work or look after my child is impossible. So grateful for my OH taking over all parenting duties today.

Long story short, what can I say to my GP to ensure this is taken seriously please? Either for investigations or a magical pill to help? I can't even take hormonal contraceptives to help as the combined pill can't be taken due to my migraines and the mini pill worsens a skin disease I have. Even when I ovulate I'm in agony and getting the poops! Just feels like I spend all month nervously anticipating ovulation or my period and the pain that comes with it 😭

My gp took an interest when i said it was impacting on my sex life (it wasnt) but the fact some poor man was possibly missing out on sex seemed to galvanise them into action.

Sounds like endo - the only way to get taken seriously is to keep seeing different doctors until one takes you seriously - maybe ask the practice if you can see one who has any O&G experience (lots of GPs will)? The only other thing I can offer is my sympathy :/

How bloody awful but not surprising! The medical world does not favour women!

Thank you. I am very rural so there's only one GP currently and a locum GP covering for the one who left. I'll ask for the female dr though and see if that helps

Could you have the coil or implant? Like you I get migraine (period is a trigger) and have been told that after using the mini pill and injection, they're my only other options.

Unfortunately not. The implant is progesterone only same as the mini pill so can't have due to its effect on other health issues and the coil isn't recommended due to another health issue. I've got a lot of chronic illnesses that unfortunately are effected oppositely to each other 🤣

That’s awful OP
I am 50 now and I could never get a GP to take my period pain/illness seriously.
DD is 17 and suffered from the beginning when she was 12. Various GPs fobbed us off and I took her to a Private Gynae last year who was great and wrote to our GP to suggest treatment. GP was still resistant until both me and The Gynae got arsey and DD is doing much better now

When I said the pain, frequency and volume were affecting my ability to work, that seemed to trigger soemthing. I've had bloods, scans, examinations, and just waiting on more bloods to see if they can find the issue. I was given TXA, which has helped reduce the flow.

You need to stress how much this is impacting on both your quality of and day to day life activities. I would also keep a daily pain and symptom diary noting everything as this will give a gynae clues. You need a gynae referral.

Greenandcabbagelooking

If these results come back as normal do not readily accept it. Keep pushing for answers. Endometriosis can cause severe pain and also heavy bleeding to arise.

Blood tests and the like will not detect endometriosis if it is present; the usual way of diagnosis is via a laparoscopy which is a keyhole surgery op.

Sounds like it’s going to be very difficult to treat as it sounds like you have endometriosis and the best managements involve hormones. You do not need laparoscopy to treat likely endometriosis. Tranexamic acid may be your best option. You do not need an immediate referral to a gynaecologist as your GP is qualified to diagnose and treat dysmenorrhea/endometriosis so please trust them and ignore previous posters - if you go in all guns blazing it can just create an awkward environment that is not necessary.

@Caneparrot if GPs are so good at recognising endometriosis then why is the average time to get a diagnosis 8 years?? No one is saying ‘all guns blazing’ but we are saying ‘need to assert the effect the symptoms are having on your life and not be fobbed off’

I likely have a skewed perspective as a GP with interest in gynaecology, and have probably unfairly reacted to people encouraging posters to “demand referral” (not necessarily on this post but thoughout mumsnet) when there are plenty of GPs who are quite capable of managing conditions without just being a letter writer.

I have also seen the study about time to diagnosis, and wonder how many of those were time to be given their label of endometriosis, whilst being offered treatment appropriate for endo in the meantime e.g. NSAIDS, COCP, IUS, TXA etc.

As mentioned above the only definitive way of diagnosing endo is surgically (though scanning techniques are improving), however I don’t think we need to be putting 10% of women under general anaesthetic in order to appropriately manage pain (surgical management is last resort and carries risk).

I am a woman and agree woman’s health is often dismissed, but the vast majority of GPs will be able to recommend management for painful periods, which is the first step in reaching an endo diagnosis. If we sent every woman off for surgery who came in with period pain the NHS would be in an even worse state than it is now (and women harmed).

Really didn’t mean to derail the thread at all, and I hope you get a GP who listens and can advise appropriately OP.

I went for almost 20 year untreated and DD had 3 years of debilitating pain, vomiting and almost constant heavy bleeding.
GPs are generally uninformed or uninterested about period issues. The usual advice is hot water bottles, exercise, diet etc. Ok, I will drag my pale vomiting daughter off the bathroom floor where she is actually crying in pain and send her for a run!
Nobody who has “normal” periods or no periods at all can understand how awful they can be - SIL commented that DNiece was such a “drama queen” about her periods and I had to explain that unfortunately the women in our family do seem predisposed to difficult periods. She literally had no idea that periods could be anything more than inconvenient and uncomfortable at worst

I appreciate there are many good GPs out but they are generalists who are short on time and have their limitations, limitations which they do not always want to acknowledge. I had a GP tell me that endometriosis is uncommon when it’s the second most common gynae problem seen in women after fibroids and it’s far more encompassing and debilitating than just heavy bleeding. Its usually diagnosed too via laparoscopy, an operation which also showed extensive endo throughout my uterine cavity. No GP ever mentioned the word endometriosis to me.

I always tell people that you will need to be persistent in order to get answers. I ended up paying to see a gynae as a private patient in recent years because I had been bleeding continuously for four months and previously prescribedTranexamic acid tablets had no effect. I had to do this after my GP sent me for a blood test, pronounced the result as normal and then said there are no more appointments available for three weeks.

@Caneparrot - my husband is training to be a GP and I made him do an O&G placement as part of his training as I am yet to find a GP sympathetic to ‘period pains’. If you are capable of managing endo then I applaud you but you are in a minority. I have sat in front of GPs crying after having to leave my job due to the debilitating pain and been told to take an ibuprofen and get a hot water bottle and offered nothing else. I am married to a doctor and most of my friends are doctors - and they are good people, but most know sweet FA about endo.

Get an urgent referral to a gynecologist. This is not normal. And something that a GP should not be dealing with imo. There is a simple blood test for endometriosis

Would love to know what this simple blood test is? Would be super useful.

Took years for me to get any actual treatment other than TXA which only helped a bit. I went privately and had an ablation in the end. Changed my life. But I had already had problems for about 16 years by then and three children.
Women are badly neglected by the medical profession.

Have you mentioned the pain when going to the toilet to the GP as well as the period pain? And frequency of bowel movements?

I don't think you are being too far off the mark about mentioning the trauma you experience giving birth. I'm absolutely not medically trained, or knowledgeable, in any way but I do think the manipulation of your bowels could be relevant.

Do you know if they were moved around internally or externally? I have no idea if it makes any difference and would assume either way could result in potential problems.

I am currently trying to research any complications that could arise in women that have had organs externalised during a Emergency section as it was something I experienced (am about to post a new thread so as not to hijack yours).

I now have immense cyclic pain and heavy bleeding 9 years down the line in addition to bowel pain and movements as you describe. I do have a previous diagnosis of IBS but this is very different from anything I've had before.

Please do mention it if you haven't already and perhaps push that angle?

I'm sorry you're going through this. I don't know if it'll help but you might not have heard of it - Raspberry Leaf tablets. I had these before my hysterectomy when my period cramping was horrific. They REALLY helped. Don't try the tea, get the tablets.