Dd (19) was refused transvaginal ultrasound

[seventyfivepercent]

Dd, now 19, has had incredibly painful periods since they started at age 13. For a few days each month she is doubled over with pain, vomiting and unable to go about day to day life.

The rest of the time she is constantly exhausted with regular headaches. Blood tests have shown she is anaemic and has inflammation. The GP doesn't seem to think the tiredness, headaches and blood results are connected to the period pain.

After years of going back and forth and being swapped from one contraceptive pill to another to try and ease the pain they finally agreed to send her for a transvaginal ultrasound, Dd was so relieved they were finally taking her seriously.

When Dd got to her appointment they refused to do the transvaginal ultrasound due to her being a virgin, and would only do an external ultrasound, this showed an enlarged ovary but wasn't clear enough to see properly. The sonographer actually said they don't like to do internal ultrasounds on virgins as they don't want that to be their first experience! I was gobsmacked and having looked into it this goes against guidelines. Yes, they should explain it might be a bit painful or uncomfortable, but the decision to proceed or not should have been Dds.

Now at her follow up GP appointment they've gone back to saying it's all normal and she just needs to keep taking he contraceptive pill, she's so fed up with being fobbed off.

I'm suspecting endometriosis, but the GP said she doesn't have the symptoms. Has anyone had success demanding an endometriosis laparoscopy, or do we have to resort to going private? I should add, I haven't been to any of these latest appointments as Dd is now away at Uni seeing her local GP, she's just asking me for help as to what to do next.

Thanks for any advice!

Honestly I'm raging reading this. Why, in this day and age, is women's healthcare so absolutely shit.

Did he actually say ‘first experience?’ That’s… really inappropriate to equate it to a sexual interaction.

Thanks everyone for all the helpful advise. I think what I will do next is accompany her to her next GP appointment, I'm probably far more pushy than she is, and if that gets us nowhere will look into going private.

in general your daughter is being treated appallingly. I can't believe she is being 'managed' using the contraceptive pill, which does no good whatsoever and can cause long term harm. She really should look into a clean whole food plant based diet as a way to manage all these issues. Period pain, endometriosis, PCOS - it's all incredibly responsive to diet and lifestyle

She very likely has endometriosis.

Firstly complain to PALS about the refusal to do a transvaginal ultrasound. Secondly GPs don't know shit about endometriosis so ask her to be referred to an endometriosis specialist service. GPs can make the referral directly.

I ended up being fobbed off for years trying to get help though and wasn't diagnosed until I was 33 in 2022 after I'd gone privately. I got nowhere with the NHS so good luck.

I'm so sorry . I have so many gyny problems including endo . They can't see it well on an ultra sound anyway . She needs an MRI , ive had these done private if that's an option? Or maybe you could suggest this on the NHS as they won't scan.

When I.went to the NHS for an ultrasound (internal) I mentioned I'd had a private MRI the week before . And she said this was a waste of time as MRIs are so much better . And ultrasounds can't diagnosis endo.

Interestingly, just quickly googled 'nice guidance transvaginal scan virgin' and the AI bit highlighted the NICE guidance that states virginity is not a barrier to scanning; then another link on the search took me to a Trust response to a FOI request about exactly what happened to your daughter: the Trust declined TVS on virgins despite it not being a contraindication, and the letter just kept repeating it was because it might hurt, basically.
The Trust is in the Royal Stoke University Hospital: it's an interesting read, no genuine justification, just repeating a stock phrase.

Thank you for this, maybe in the future women will go for an MRI rather than the waste-of-time-and-money tests!

Most endo doesn’t show on an ultrasound, mine did but only as it was so severe
MRI is preferable
I started my periods age 9, they were always heavy and painful. A decade ago I said I thought I had endometriosis and as I didn’t want the pill they wouldn’t even refer me
i finally had surgery this May and it was everywhere, my bowels, my bladder, ureters, cysts…. It took them a full day to get it all out

my surgeon said painful heavy periods are normalised but they are NOT normal

It’s interesting isn’t it, because something hurting usually isn’t a barrier to the NHS doing it anyway, particularly where women are concerned. And the reason the OP’s daughter needs it is because of monthly intense pain.

Regardless, I think my issue is with the way it was worded as ‘first experience.’ Equating it to a sexual experience.

I think the statistic is it takes on average 8 years from first going to the gp to getting an endo diagnosis.

I had to push for years to be taken seriously. Mine was on my bowel and I only got tests once I’d lost so much weight I had an unhealthy bmi. People get different symptoms depending what areas are affected, I think drs just fob women off as a matter of standard practice. Ultrasound won’t diagnose endo you need the laparoscopy. Even then that doesn’t always help much. I was basically told have a baby that will fix it. And I hate to say it that was the only thing that did help, although it does come back and you can’t keep having children every 4 years ffs

I’d honestly just go and get a private ultrasound, I had one to diagnose my pcos and it included blood tests, £350 all in. Not worth the stress…

I was going suggest trying private if you can afford it.

My DD is pissed off with GPs because every appointment they try to push the PIL. Covid, flu, ingrown toenails they always push PIL,

I would complain, all fit a second opinion and potentially chance GP. Also get her off the contraceptive pill. Does more harm than good

That is a shocking thing for that man to have said to her. Please complain about him.

This is actually worth a formal complaint. How disgusting. Your poor daughter.

The only way they can find endo is through a laproscopic investigation, so a t/v scan will not confirm any diagnosis any way. It sounds like a private consultation woudl be the best option as they have the time to be more thorough. As you don't have a lot of faith in male doctors, maybe find a female doctor.

Endo is nortoriously difficult to diagnose and treat, and sometimes symptom managment can be better than trying to get a root cause. I have had patients who have been disabled by period pain, had several laps to remove the endo the pain didnt change.

Using a tampon is a very different experience to having someone insert an object into your vagina. If you haven't have sexual intercourse which has a considerable degree of "relaxing" activities associated with it, then you could be at risk of vaginismus (which is certain in this case) and will just be a terrible experience all round for minimal value.

I think some feedback would be useful, but I dont think anything said is "disgusting".

To be fair, the majority of doctors she has seen have been female, it was the sonographer that was male, I’ve lost faith in any of them to investigate fully.

I promise you, GPs tend to know NOTHING on endometriosis. You have to become your daughter's advocate with this and you both need to educate yourselves on it (I don't mean that in a mean way - I mean, it's the only way to work through the system). I have stage 4 endo and it definitely sounds like endo symptoms.There can be so much dismissal of it. I would also push for a private scan with a specialist who can cover endo and other conditions. I had a private scan with a brilliant consultant, I think it cost about £400. They did internal and spoke through all findings and I had a report by the time I was back in the car. That, plus imagery I could take and go back to the NHS. This was enough evidence to push through to an MRI with NHS. There are some fabulous endometriosis groups on facebook. Some have very detailed info on the process you need to follow and a huge amount of knowledge on there. Happy to answer any questions you might have!

It depends on the severity of endo, the quality of the scanners and the sonographer. Many people (myself included) are now getting diagnosed by t/v scan. Not all, but many are.

Pretty sure it'll be endo op keep pushing it takes years to get a diagnosis which is a complete joke but just the way

GPS will always gob you off she does have typical endo symptoms. It's so hard to get listened to with endometriosis please keep going back

Why is a medical professional sexualising a medical procedure by talking about it in sexual terms?!

They may have just meant causing shock and pain which in the future could make her scared of sex.