9 PMDD mythbusters
Do you know fact from fiction when it comes to premenstrual dysphoric disorder (PMDD)?
If you feel like you didn’t get the help you need from your doctor, nurse or a gynaecologist, what can you do?
Making an appointment with your GP or nurse is usually the first step towards getting the right treatment for any problems with your period, including heavy bleeding, painful periods or irregular cycles.
The government’s Women’s Health Strategy for England found that 4 in 5 women said there had been times when they, or the woman they had in mind, had not been listened to by healthcare professionals.
Many women said they had to persistently advocate for themselves to get a diagnosis, often over multiple visits across months and years. Gynaecological conditions, such as endometriosis, can take women an average of 8 years to get a diagnosis.
What can you do if you find yourself in this situation? Our ambassador, Dr Nighat Arif, has some essential advice and tips to help get the answers you need if you feel like you aren’t being heard, or are feeling dismissed by your doctor.
How many times have you heard that severe pain, heavy bleeding or irregular periods are a “normal” part of having a period? Or something you should just put up with? It’s not – and if your doctor, nurse, or any other health professional tells you this, you have the right to speak up.
“The first thing to do is tell your doctor that you’re feeling dismissed,” says Dr Nighat. “You can say to them, ‘I’m sorry, but I feel you’re dismissing my point’. This gives you an opportunity to express your concerns, while they get an insight into how the appointment is going and can address your worries.”
It helps to be prepared for your appointment – find out how in this article – so you have evidence of your symptoms, the impact they have on your life, and you can ask questions about all the different treatments available.
You may find it helpful to take information about symptoms you are experiencing and relevant guidance, such as from the NHS UK or NICE websites.
“If you write down what you expect from your doctor and what you want to get out of the appointment, it can help you better navigate your care,” adds Dr Nighat. “You could also take someone with you, like a partner, family member or friend, for moral support.”
“It can help to write notes during your appointment, so you don’t forget any details, as there can be a lot to take in and remember.”
There are several ways your hospital or GP surgery can help if there are specific barriers to you communicating your needs. You can ask if a translator can be booked if English is not your first language. If you have visual or hearing difficulties, ask the practice to provide you support with health information in Braille or in British Sign Language. You can also take a family member or health advocate along to help you to share your concerns.
If you’re not happy with the answers or treatment suggestions from your doctor, you have several options. You can book an appointment with an alternative healthcare professional at the surgery. You can ask to be seen by someone who specialises women’s health and try to book a double appointment.
National guidelines from NICE say you have the right to choose or decline treatment, or ask for a second opinion, and healthcare professionals must respect your decisions.
Dr Nighat says: “There’s absolutely no shame in asking for a second opinion – a good doctor should be happy to offer one. If I feel I’m not able to address a patient’s concerns during their appointment, I’d want a second opinion too!”
You can also ask to be referred to a specialist like a gynaecologist, particularly if this isn’t the first time you’ve seen your GP about your periods or you need more specialist care. It can help to have notes and records of any previous consultations to refer to.
NICE says doctors should refer you for specialist care if you’re experiencing period pain or heavy bleeding and at least one of the following applies:
A gynaecologist can give you a second opinion and may recommend different tests and treatment options. If you suspect you have an underlying condition like endometriosis, PCOS or fibroids or adenomyosis, ask if your gynaecologist is an expert in that area.
If not, or you’re unhappy with their treatment suggestions, you can go back to your GP and ask for another referral.
Asking for a second opinion, or pushing back against treatment options, means you need to be clear and persistent about your needs. Dr Nighat says: “This requires confidence and being assertive, but the results could be life-changing.”
Don’t forget that your GP, nurse or gynaecologist is a partner in your healthcare; you should be involved in any decisions around your treatment, and you don’t have to accept the first solution you’re offered. Find out more about shared decision making in our article on preparing for your appointment.
“All healthcare professionals want to help you get the answers you need, so it’s worth persevering,” says Dr Nighat.
But if you feel your doctor or another health professional isn’t taking your ideas, concerns and expectations seriously – sometimes called medical gaslighting – you can leave feedback for them or make an official complaint. Dr Nighat says: “Your health is a priority, so make sure you don’t get dismissed.”
On the occasion where you may receive poor care, you can make a complaint to your GP surgery – you can speak to the practice manager and/or fill in a form. There will be details on the complaints procedure, and usually the receptionist or practice manager can provide more information on this.
If you’ve had poor care in a hospital or clinic, there should be details on how to submit a complaint or feedback, usually through the Patient Advice and Liaison Service (PALs). Visit the NHS website for more information on how to complain to the NHS and PALs.
There are also support groups and helplines available where people with similar period problems and journeys share their experiences which may be helpful.
Our periods information hub is here to help educate and empower. Get more information and support here.
Read about women’s experiences of living with gynaecological conditions here.
If you have any symptoms or concerns, always speak to your doctor.
Do you know fact from fiction when it comes to premenstrual dysphoric disorder (PMDD)?
You might be nervous about getting your first period, or you might have had periods for a while but are finding them difficult. You’re not alone.
Don’t worry, we’ve got the lowdown on how to feel supported while sorting fact from fiction.