What will GP offer for awful periods?

[ColinRobinsonsfamiliar]

I need the appointment to be worthy iyswim. Can’t get an appointment for weeks etc.

So pain (and I mean doubling over type pain) and pressure in my undercarriage mid cycle. Usually to one side, usually lasting about 4-8 hours.

Very strong period pains. So the type that affect me to such an extent that I sweat, can’t breath for a while and cause me to hold my stomach or stops me in my tracks quickly followed by a gush of blood and huge clots.
Paracetamol does help.
I know I must be anaemic due to the heavy blood loss.?

Ive read of women going back to their GP repeatedly, being fobbed off given iron tablets or something to stop the heavy blood loss.
At what point do they refer you to gynae and how long does this take?

Im around menopause age now, have suffered probably all of my adult life like this, hoping for periods to stop but even though the time in between periods is longer, they still arrive each month.

If finally I go to my GP, what will they do?

You need to make it clear you want to be referred for further investigations.

You need to have a hysteroscopy (they use a small camera to see what is going on inside) or an ultrasound to find out why this is happening to you.

It could be fibroids or polyps that are causing the bleeding or it could be hormonal issues but your GP won't be able to tell without further checks so don't let them fob you off until you get proper tests booked.

They should also do a blood test to check your iron levels.

I had similar symptoms to you and it tool a lot of fighting on my part to finally get the proper tests done and be diagnosed with endometriosis and adenomyosis.

There still many GPs who are clueless about periods and will try to minimise your symptoms and the effect they have on your daily life.

That’s my worry.
To be told is “normal” and to get on with it.
It’s not and I’m suffering a lot.

I take the pill constantly so that I don’t have any bleeds.
could that be an option for you?

Op I am exactly the same as you. I have just had the mirena coil fitted on the recommendation of my gynaecologist. It is game changing. I don't know why I didn't do this years ago. Periods are now so light that I only need a liner for a day or so. Honestly I feel like it has changed my life.

Hi OP. I went summer 2021 after years of heavy periods, some painful but mostly scary blood loss. My journey went:

First they gave me the mini pill and put me on waiting list for mirena, and did blood tests. Blood tests showed severe anaemia, so iron tablets.

Mini pill made me bleed constantly. Finally got mirena in February. Bled it out five weeks later. At that point GP suspected fibroids and sent me for a scan. That took another 4 months. Scan showed fibroids.

Gynae locally was a 26 week wait for non-cancer referral but I jumped the queue by bleeding so badly I collapsed and was admitted to the ward. I then got a consultant who said I need a hysterectomy and I’m a P3 priority - not sure what that means. That was mid June and he said it would likely be this year but I’m still waiting.

in the meantime I’ve had Prostap injections to stop my periods, norethisterone because the injections didn’t stop things, and tranexamic acid which does stop the flooding but doesn’t treat the cause.

So there are lots of things they can do. Loads of women love the mini pill or coil, they just didn’t work for me because my fibroids are big. But I think you do have to do all the things the GPs need to try because gynae won’t take you till they’ve failed (and they might work!). Initially GP was saying I can’t refer you unless it’s cancer, they won’t accept the referral. I think locally you can now be referred. The backlog in gynae is huge. Good luck, and be persistent, but you might have to jump through the hoops they need to tick off xx

I’m not sure of my options at my age.
I am of course fat because of the peri meno, so at a higher risk of DVT, but other than that, I don’t know what I can and can’t have.

Will HRT & some kind of contraception mix?
Will HRT alone affect my periods for the better?

Can I still donate blood if I am on HRT?
I just don’t know.

Given your age I'd be demanding a referral and asking for an endometrial ablation.

Hormones were a no go for me for various reasons and until I'd had my children they were the best option the docs had for me.

This time last year I demanded more and asked for an ablation.

I had it in February and it has changed my life! I still get periods but they are so light now. I hadn't realised how unwell my periods were making me until I had this done.

No regrets at all.

*Will HRT & some kind of contraception mix?
Will HRT alone affect my periods for the better?

Can I still donate blood if I am on HRT?*

If you are on the COP you don't need HRT
You can have POP and HRT - because that's what my menopause dr has done with me. However GP didn't know this.

HRT alone probably isn't the answer to your periods - you either need to stop cycling so no periods, or find out why they are so heavy, or both

Yes you can still donate blood. However if your periods are massively heavy, that blood is better off inside of you.

If finances allow I would phone your local private hospital and arrange an initial consultation with a gynae. I suggest that too as NHS waiting lists for gynaecology are miles long currently. Such problems are outside a GPS remit so you should be referred onto a specialist.

Your symptoms could well point to endometriosis being the cause and it is certainly in your interests to find out why this is happening as well as treating the symptoms. Endo is a common cause of underlying and cyclical severe period pain.

Also I insisted on speaking to women GPs…

My nurse practitioner was very proactive at first and I had a smear, blood tests, ultrasound and internal scan. This was because my periods were 14 days on and only 12 days off.
When everything came back normal (astoundingly not even anaemic with an iron level of 10) they said it’s just me and said I can go back on the pill. 18 months later and I STILL breakthrough bleed on the pill. All I can suggest is keep pushing or go private if you’re able.

I had a mirena coil fitted a few years back, for a similar issue. No real issues mid-cycle, just a bit of discomfort. But every month, during my cycle, my pain was just getting worse and worse. I was bedridden, considering calling the minor emergencies number, on the NHS, when I realised maybe calling the doctor, in the morning, was a good idea. When he heard I'd gone off birth control (no longer needed) he suggested that. I wasn't as keen, due to having some side-effects, so he suggested the mirena. It was AWFUL to have it put in. Truly horrid. However I'd do it again in a heartbeat. Problem totally solved. Very few periods with very little bleeding. No pain whatsoever during them. I highly recommend it.

Honestly OP I am you. Also peri menopausal. Please consider the mirena. It is brilliant.

My GP is very quick to make a referral in these instances. I had problems with heavy bleeding and severe pains a few years ago - was referred and diagnosed with fibroids. Oddly enough the pains stopped after a few months so I didn't pursue this any further. Bleeding managed with tranexamic acid.

Recently the bleeding got heavier and out of control again. Back to GP and diagnosed with borderline anaemia, and referral again. Also started HRT (Im mid 50s). In the meantime the pain came back so badly I had to go to A&E, which led to ultrasound and consultant gynae. Now diagnosed with adenomyosis and awaiting hysteroscopy.

Your symptoms sound like mine which is why I mentioned adenomyosis - have a look. If you can take ibuprofen, take that alongside the paracetamol. Codeine as well if you can. Start the P&I before your period if you know when it's coming.

TLDR - some GPs are very good at referring. If yours isn't don't be fobbed off. It's not normal and none of the professionals I've seen have suggested it is.

This is going to sound a bit odd but I was recommended taking a photo of my clots ( they were huge at the time though) and actually measuring the amount of blood I lost to help convince Gp to take me seriously. Shouldn’t have to of course but might be worth doing if your clots are large ( mine were palm size at this point - due to fibroid).

Just remember to delete from your phone afterwards 😉

Similar issues here. I'm 40 and since June have had 2 extremely heavy periods a month. Dr did bloods then a scan due to severe pain. No fibroids or cysts but endo wouldn't show on an ultrasound. Suggested mirena but they couldn't get it in (cervix spasmed, horrific pain) Now on the waiting list for a fitting that uses local to numb the cervix to stop the spasm. Offered me the pill which I've not taken in over 15 years....one month in I remember why....

The cause needs to be determined as well as having the symptoms treated.

Given also that you've suffered similarly your entire adult life it may well be that endometriosis is the root cause of both heaviness and pain. Any pain that is cyclical in nature and or gets worse up to and including menses should be checked out by a gynae to see if endo is the cause.

Unfortunately they will probably tell you to take a couple of paracetamol and exercise.
We went through 2 years of this with poor DD until we saw a Gynae Consultant privately and she put together a treatment plan and sent it to the GP.
There was still some resistance but after me getting quite “assertive” they agreed to prescribe what was suggested

And if your GP is unhelpful then complain to their practice manager. Alternatively move GP practice. I would also look at contacting a private GP to consult with and from that conversation obtain a referral letter.

In other words… get myself ready for battle.
FFS. It makes me so mad. People are suffering, not only are they suffer but they are having to fucking fight to even be heard from the get go never mind get a diagnosis or treatment.
Paracetamol and exercise my arse!

Thanks everyone! It’s good to share and help each other out with info. Hey, it’s just good to speak to others who “get it”.

Echoing all the above re getting this investigated. Sometimes it makes you unable to go to work can tick another box on referral criteria.

Meanwhile if you can tolerate it, take max dose Ibuprofen for 48 hours before you're due on. In many women this has quite a good impact on heaviness and pain levels.

Good luck.

I’m 45 with endometriosis and can’t face ever having ovulatory periods again. I was on the combined pill continuum but there’s a clot risk as you get older.
I’ve gone for Mirena plus oestrogel. Would that be an option for you?

get myself ready for battle

It's not a given. I've never had to battle, always been listened to and given referrals as required.