Morning After Pill side effects, and finding a doctor.

[Proinsísín]

I've searched through the articles here, and googled as much as I can... hopefully these questions are okay?

My partner and I were grinding/rubbing against each other and he came (outside), and he wants me to take the morning after pill. I've looked up the side-effects as well, although there seems to be three types, and on a lot of sites they were lumped together. (Nausea, vomiting, bleeding etc.) I have a very regular period time-wise, but it's gotten very severe in the last few years. (I take meds which usually relieve the worst bits)
I want to be safe, but I don't want to make myself sick either! Can anyone tell me how severe the side-effects are - my period can be incapacitating to say the least! I don't know if that means anything? I'm afraid that I would get very sick and need to go to a doctor (who might be very judgemental or not want to help me)
I've never had intercourse. He was concerned, though I thought the chances were very low, but the articles I read said any same-sex genital/genital contact - does that include if he came towards the front of my vulva instead of very near the vaginal opening? Usually if we do anything we use a condom.

Basically I'm concerned that the side-effects would be linked with my period, which can be scary and maybe serious (since I wouldn't have taken my period meds)? But having a child would be far more serious, so I will 95% take it.
It says if I start vomiting I should see a doctor - I think if I look for a younger one I would be more likely to find someone supportive?

My partner really wants me to take it and is ready to travel with me to another town or city today to get it.
For context abortion is illegal in my country, and I've heard a story or two of people being refused the pill. I definitely don't want to end up having to even consider that choice, and if I did I am certain I would be shamed if anyone found out.

Also it could delay my period, so I think I should take a pregnancy test if it does... do I need to take more than one?

I don't know if you can answer any of this - hopefully it's coherent, it's way longer than I intended. I don't want to make myself very sick unnecessarily, and I want to find an un-judgemental doctor if I need one. Hopefully I'm not being too silly!?

I've read the "Pregnancy Fear and Anxiety Policy". I am not sure if this post is okay, but I hope it is. I've used the website since forever, and I definitely do not mean to be disrespectful!!!

[Proinsísín]

**"Abortion on demand"/by choice is illegal I meant, but that doesn't really change anything for me unless my life is in danger!

[Redskies]

Hi Proinsisin, and welcome to the boards! Thanks for being so thoughtful about our site use rules.

You said you were grinding against each other - you didn't say that either of you were wearing any clothes, so I'm assuming you weren't? But to get it out of the way at the beginning, if either of you were wearing any clothing over your genitals, there's no chance of pregnancy, because pregnancy can't happen through clothes.

If your genitals were naked togther, there's a chance of pregnancy. If he ejaculated on your genitals or right next to your genitals, that makes the chance of pregnancy a lot higher - if he ejaculated on your vulva, then yes, that's ejaculation on your genitals. "Outside" is a little vague: if he didn't ejaculate on you, or ejaculated anywhere else on your body like your leg, for example, the ejaculation probably isn't relevant. But if he ejaculated on your genitals, that's a pregnancy risk.

As you don't want to become pregnant, if he ejaculated on your genitals, we would definitely recommend taking emergency contraception. If he didn't, but you two had been rubbing naked genitals together, the risk of pregnancy is lower but does still exist. If it's very important to you that you don't become pregnant - and it sounds like it is - then taking emergency contraception is a thing you can do to lower the risk further. Taking EC is really about what You want and the level of risk you do and don't feel comfortable with.

EC is one of the safer medications that exist. Side effects are temporary, and only a small minority of people feel badly affected. Some people get no side effects at all - it's not possible to predict how any particular person might feel, because everyone's body is different. It's pretty common for the menstrual cycle to be a bit wonky for one or several cycles after taking EC, so it's not possible to predict when anyone's bleed might happen: there isn't one thing that happens for everyone. Some people get nausea, but that's just a bit unpleasant rather than a medical concern. There'd be no need to see a doctor if you vomited, not if there's no medical reason you need to see a doctor if you vomit any other time. Vomiting after taking EC is only a problem per the effectiveness of the EC: vomiting within a couple of hours wouldn't have given it enough time to be absorbed, and it's recommended to take another dose or use another method like a copper IUD.

Have you ever seen a doctor about your periods?

I'm glad that your partner is willing to help you access EC - that's important in a partner! Taking it or not is Your decision, though, because it's your body

I can have a look for you about access to EC and to appropriate doctors. I'm sorry that it's not what it should be Posting this for you first!

[Redskies]

Further to the above-

I've done a bit of quick digging for you. You should be able to get emergency contraception on prescription from a doctor or family planning clinic, or buy it from a pharmacy. If you prefered to go to another town to get it, that's of course up to you, but healthcare professionals are supposed to keep this confidential.

From the second link below,

What can I do if my pharmacist or doctor won't provide me with an emergency contraceptive pill?

Unfortunately there may be some pharmacists and doctors who refuse to provide emergency contraceptive pills because they do not agree with it. They are allowed to refuse to provide the service but they are not allowed to impose their beliefs on you, or treat you in any way that suggests disapproval of your actions.

If your pharmacist or doctor will not provide you with an emergency contraceptive pill, they are obliged to refer you to a pharmacist or doctor that will and you must be able to access that pharmacist or doctor in a reasonable amount of time.

If a pharmacist refuses to provide you with an emergency contraceptive pill and will not refer you to another pharmacist, you can make a complaint to the Irish Pharmaceutical Society: info@pharmaceuticalsociety.ie.

If a doctor refuses to provide you with an emergency contraceptive pill and will not refer you to another doctor, you can make a complaint to the Medical Council: complaints@mcirl.ie.

So, if you did have difficulties with a doctor or pharmacist, you can first remind them of their obligations (refer you to someone else who will serve you and that you can access), and then remind them that they can be reported for not meeting their obligations. Most people will do what they're supposed to in that situation!

These links might help you out:
https://www.ifpa.ie/Sexual-Health-Servi ... traception
https://www.ifpa.ie/Sexual-Health-Servi ... -Explained

To find appropriate and non-judgy doctors, I think I'd try starting with the Irish family Planning Association https://www.ifpa.ie/ and asking their advice. You could also put "family planning <your region/city>" into a search engine and it should give you family planning clinics in your area. I would usually expect staff in family planning clinics to be supportive of full reproductive rights, and non-judgy.

[Proinsísín]

Thanks for replying so quickly and thoroughly!!!

I actually saw your message on the way to the city, and it was very reassuring. I decided to take it. (I only had my phone with me at the time, and I get car sick, which is why I left a reply until now) I had an appointment about a new job in the morning, and then a lot of miscommunication with my partner, so the morning/afternoon was not great; I got a bit emotional.

It might have been a bit OTT traveling that far ; my partner thought we should just go closer, but I'm glad we did anyway. I was way more comfortable. I live in a small town, and I swear everyone knows each other one way or another. I figured in a city/or further away no-one cares who I am or what I do. (I have no problem defending other people, but when it comes to receiving shame myself I find it tough! )
The pharmacist was grand, and my partner was with me the whole time, which really helped. I haven't got really sick either. Just a bit dozy after two hours. So I'm very relieved that way.
We got ellaOne, it says it works by delaying ovulation... I track my period every month, and I'm 99% sure I ovulated a few days ago. Do you know if that will stop it working? I couldn't find any info on the packet, and the pharmacist didn't say.

Yeah it was direct with no clothes between. I'm a bit awkward talking (typing) about it - sorry! We were lying down sideways, and he ejaculated on the front of my vulva from behind if that makes sense? So on my genitals, but not at the vaginal opening, although it could have gone there too without me realising. Thanks for the answer.

I've seen a doctor about my periods... I found a doctor when I was in college (in another part of the country) who believed me and prescribed me stronger painkillers and an antinauseant. In her words it was a "quality of life issue". I've got the same prescription from another doctor where I live now on the basis of the first one. To be honest it only makes it bearable, if that, and I'm still doubled over in pain at times with it, even when I take the medicine in time. I had a doctors visit in the last two months or so, and I mentioned it... it's very clear to me that they don't understand, and I feel like I'll be dismissed as a hypochondriac if I continue to explain. It's not just pain and vomiting either - it's a lot more than that.

Periods and EC were linked in my brain a little bit since they're the same system, as it were... so I was afraid it would trigger something.

Thanks for the links, it seems like IFPA have a totally different approach than I'm used to!
I feel a lot better now. We've agree to take a step back - and be much more careful if anything happens! I'm going to take a test if my period is late or different.

[Proinsísín]

- actually I found this:

If ovulation has already occurred, ellaOne is no longer effective.

http://www.drugs.com/uk/ellaone.html
So... I told the pharmacist about my tracking too, yet she still gave it to me I'm not sure what to feel or think about that.

[Redskies]

I'm glad the information helped, and that you had a good experience getting the EC! Although not so much with the other things going on, all sounds a bit much for one day.

With your period tracking, do you do daily observations and charting of your cervical mucous, basal temperature and cervix position? At least some of those things are necessary to be able to know accurately when you ovulate. Most people aren't going to know with any accuracy when they ovulate, so taking EC after a risk is always a good thing to do. Also, you said it was a few days ago: if you're correct and accurate about that, your reproductive cycle would very likely put you in the clear per pregnancy risk: after ovulation, an egg only has a small time window, about 24 hours, in which it can be fertilised. It's possible for another egg to be released around the same time, so add on another 24 hours to allow for that, so after 48 hours after ovulation someone is no longer likely to be fertile in that cycle. All that, of course, relies on careful and accurate charting, and being correct about ovulation in the first place!

Would you like any information about different contraceptive methods, or how to access them, for the future?

I absolutely agree with that early doctor that very, very rough periods are a quality of life issue! It does sound like no-one has really investigated why you have the symptoms that you do, and with you describing it as being so bad and having got worse, I really think some investigation is likely the way forward, to enable you to have treatments (or at the very least things to ease your symptoms) that are most appropriate for what's going on with you. I'm so very sorry this most recent doctor responded the way they did - that's not okay, and really, they're displaying their own ignorance. Unfortunately, not enough doctors are really on top of menstrual issues as a medical issue Would you like to see a doctor who'd approach it better? If you would, we'd be happy to do what we can to help with finding or accessing one.

[Proinsísín]

Thanks!
I'm running out to work soon, and won't be back till late. I'll reply properly tonight, or tomorrow.

[Proinsísín]

Sorry there! Thanks again for your reply!

I generally chart my periods, and discharge. I don't have a thermometer yet, and I don't do a cervical check because it's too difficult to insert a finger or anything. I do get very distinct discharge though, and I get quite hyper/playful and flirtatious, and I feel different. (I'm usually pretty shy, and I note any mood swings like that too) It's almost always exactly 28 days too (it was out by one week this year, but so were my ovulation symptoms) it was the evening of day 18 that we had an accident :/ .

Information is always great. I've found and read the articles on it (very informative, thanks! , but if you know where to find them here it'd be great.

I did a hormone check with the early doctor which came up clear, but it was left at that. I'd definitely like to find a better doctor. I'm worried about how it will affect my employment, and how it will affect my health in the future. I've felt angry at times about it before, if it was any other part of my body it would be taken very seriously. I've collapsed in front of people before (mortifying) but because it is my period, if they insist I say why, it's a case of "oh right, (and ignore)". (And an attitude that I should be more in control) I'm trying really hard not to rant, sorry!!!

[Sam W]

Hi Proinsisin,

As far as more information on birth control, this article is a really good place to start. It walks you through a bunch of options and tries to find one that matches your needs: Birth Control Bingo!

I've got to say, that sounds like a pretty rant-worthy situation. Have you had any luck in finding a new doctor to talk to?

[Proinsísín]

Thanks!

No luck. I haven't made any movement on it since I last posted. I've just been working.
I'm not sure where I'd even start to be honest. I've seen various doctors before. (I've also suffered from a different health issue. Nothing happened until I said "Please do A/B/C tests for X/Y/Z")
I don't know anyone with symptoms quite like mine, so I don't know what to insist on. My sister also gets sick, but a little different, and not as extreme. I'm not sure if it's appropriate to post symptoms here... so I'm a little stuck on that.
It's not every month/period at least.

[Redskies]

It's fine to post about symptoms here: we're a sex and relationships education site, so details are fine - and unremarkable to us! - whenever they're relevant. Of course, we can't diagnose anything because we're not doctors and it's over the internet, but we may be able to help with suggestions about how to approach in-person medical care for your needs.

[Proinsísín]

Thanks

I wasn't sure if posting them was getting too medicall-y. (I'm still not sure actually )
I've posted the symptoms below. I'm not sure if it's any use, or helpful at all, and I apologise for the details/grossness!

I had very easy/normal periods until about 20yo.
I get a very sudden onset (if it's going to be a bad one, I'm floored within a half/hour - an hour, if I'm not I know I'm fine. )
Very bad pain on and off, possibly like contractions. Nausea, vomiting. If I can keep the pain under control, I won't throw up, otherwise it's the whole body convulsion type. Diarrhea while I'm at it.
The pain is so bad if I didn't have painkillers I would want the organs out. I'm not usually one to be dramatic, but I'm perfectly serious on this.
I get very weak - it can be difficult to phone someone (e.g. to pick me up), sometimes even to hold up my head when I get the worst ones, disorientated, extremely hot, and cold. Profuse sweat.
I've gotten a temporary paralysis a few times (this is only when it's really bad). The best I've gotten from a doctor (and a close relative) is "that's impossible"... having done my own research the best I can tell is maybe the vomiting triggers the vagal nerve?
The paralysis never last longer than an hour to a few hours, vomiting several hours, pain and weakness 1-2 days. Naturally it affects my ability to work normally on those days, and leaves me quite vulnerable.

Again, I'm sorry to be dramatic and TMI about it, I really am trying to keep it matter-of-fact.
I definitely don't expect you to diagnose anything! Anything that helps is great, nothing expected.

[Heather]

Can I ask if any of the doctors you have seen about this have been either OB/GYNs who specialize in menstrual issues, and/or a neurologist? And if you have seen an OB/GYN with that emphasis, can you give me a picture of what kind of tests they've run for you so far and what their findings have been?

[Proinsísín]

Thanks for the reply!

No, I've only seen GPs.

I did see a neurologist about other problems (which actually was probably the same year this started, but I'd been having the other symptoms before). I got a regular MRI, and got some movement checks in a different clinic. Everything came up clear. (Note: by the time I got tested my symptoms had reduced to an unnoticeable level anyway - the waiting list is long) I believe the neurologist regarded the other difficulty to be psychological.

An older doctor recently suggested going on the pill as a solution. He didn't suggest any checks. I do believe there must be a cause however.

[Heather]

Okay. So, I think that this has probably been a big part of your problem. GPs are just very rarely going to be that well-versed about anything more than pretty basic OB/GYN care (things like pap smears, basic contraception, STI testing and treatment), let alone in much more complex things like severe menstrual pain and reproductive pain conditions. Really, if a patient comes in with severe and unexplained menstrual troubles like you have, a GP should, per best practices, be referring you to an OB/GYN outright, because they just won't have the education or training needed for most folks in this kind of spot.

Is it possible for you to seek out -- or get a referral for -- an OB/GYN at the very least, and more ideally, an OB/GYN who specializes in severe menstrual pain and side effects?

[Proinsísín]

I'm not sure, but I can make a solid effort to find out.
(I like to be proactive!)

Besides asking my GP (which I will do), I'm not sure how...
Do you know if there is a data base of doctors or OB/GYNs, and their specialties? (I know that it's a different country etc.) If I can find one, I might even be able to ask one how to get referred if my own doctor can't or won't oblige.

EDIT: and thanks again!
The older doctor also tried to tell me it was "normal to have cramps"

[Heather]

What I'd suggest is just saying to your GP, "Can I get a referral to an OB/GYN, please, ideally one who specializes in menstrual pain disorders?"

Generally, in national health services, you're not going to be able to just pick a specialist and go with it, you're going to have your primary care doctor (your GP) write you/provide you a referral. If you would like to be able to have at least some options, you can ask them about THAT, by asking them to suggest a couple of different OB/GYNs they'd suggest, then research them from there. But that you have a referral -- effectively, an order from a GP that validates your need for that care so it's covered by your healthcare system -- is what gets you in the door of a specialist, in general. Does that make sense?

In the bizarre even they will NOT refer you to an OB/GYN, I would suggest asking WHY they will not, and asking what THEIR specialized education -- including current education -- and training is with severe menstrual pain. But really, with the kind of symptoms you're reporting, there is truly no sound reason not to give you a referral, and not doing so strikes me as counter to your health, which a GP is supposed to be supporting. And a good GP knows full well they are not anything close to a specialist of everything: the "general" in "general practitioner" makes that patently clear.

[Proinsísín]

Thanks
I just edited the post above: my (last, older) doctor thought it was normal.

I know I need a referral. If I know what I'm looking for I can ask the doctor to help. I don't know if we even have one for menstrual disorders, I can only presume we do. If I know, and the doctor isn't sure when I go for an appointment, I can tell them "I've checked it out and there is a specialist in such-and-such a place". Only if they're unsure obviously.
I doubt they would say no, but I might be fobbed off, and then I'll have to pay for another appointment to try again, which gets expensive.

I had a bad health problem before, and I've found being very (politely and respectfully) proactive gets things done a lot faster.
I'm lucky enough to have health insurance too, so that could potentially help, depending...

[Proinsísín]

If I was stuck I would probably ask the first doctor who helped me. (Although she is far away now)

[Heather]

Really, ANY GP you have had and brought these concerns to should be able to give you a referral.

Pretty much any OB/GYN has at the very least a level of education about menstrual pain disorders almost no GP will. So even if you can just shift from a GP to an OB/GYN for this, you're already likely to get much better, more informed -- and more currently informed -- care.

[Proinsísín]

Ok, thanks

[Heather]

Sure thing, hope you can find someone sooner rather than later!