The Day I Realised Patients Shouldn’t Have to Fact-Check Their Doctor
By
This isn’t my usual kind of post, but it felt important to share. I’ll be back soon with my regular end-of-month round-up — complete with writing updates, creative highlights, and probably a touch of vampire chaos.
I’m stepping outside of my usual comfort zone about talking about books and my writing, to delve into something very important to me, which I know affects many with a uterus or ovaries — whether you’re a cis woman, a trans man, or a nonbinary person.
I’d also like to acknowledge that trans men and nonbinary people face these same challenges — and often greater ones — when accessing gynaecological or hormonal care. Everyone deserves to be listened to, respected, and treated with dignity in these spaces.
For a bit of background, I have experienced menstrual-related mental-health issues for as long as I can remember. It wasn’t until I saw this video from The Kitchen & Jorn Show, in which one of the hosts, Jen, discusses her premenstrual dysphoric disorder, that I discovered what PMDD was, and that I was experiencing symptoms of it.
Earlier this year, I spoke to my GP about treatment options beyond anti-depressants, such as chemical menopause. The GP referred me to the gynaecology department at the local hospital. I received an appointment for the end of September, which coincided with a second gynaecology appointment a few days later regarding having my Mirena coil replaced, as I had had it for five years.
The first gynaecologist I saw, a male locum, was wonderful. He explained everything in detail. He outlined what would happen next and what steps he advised if HRT was unsuccessful. I felt not only listened to, but also informed, and I left the appointment excited that I was finally going to receive treatment that would helpfully improve my quality of life.
The locum also recommended I have my Mirena coil replaced, and not to begin HRT, until this was confirmed, ‘to protect the uterine lining from the effects of estrogen, which can cause it to thicken.’
That was fine, as I actually had an appointment scheduled for a few days later, with a different gynaecologist to have my Mirena coil replaced. My locum gynaecologist was happy for me to begin treatment the same day as the coil replacement.
Then it was time for my second gynaecologist appointment, this time with the department head — a man I had seen some five years previously when I first had my Mirena coil fitted.
I told him everything that had happened in the first gynaecologist appointment, and asked if he could sign off on my HRT prescription.
This is where the problems started.
First, he looked at my prescription and made a disparaging remark about the other gynaecologist’s handwriting, which struck me as highly unprofessional.
He then decided to overrule the first gynaecologist who had prescribed 75MG Estrogen patches to start with, as the symptoms I described to him were severe, and instead insisted I should start with the standard 50MG.
Next, he misinformed me that the Estrogen patches were to be changed once a week. This contradicted what my first gynaecologist had told me, plus the medical standard. When I mentioned this, he had to look the information up online. It turned out my original gynaecologist was correct — the patches should be changed twice weekly.
As he was discussing when I should change my patches, he made a comment about being certain his wife was on the same patches and changed hers once a week. He then added, “But I can’t be sure, as I tend to avoid my wife.”
This made me very uncomfortable, but I said nothing. I am an autistic woman who doesn’t like confrontation!
Finally, I asked about having my Mirena coil replaced, and that the first gynaecologist I’d seen had insisted I could not begin HRT until I had a new coil. The second doctor told me that it was ‘outdated’ information, and that the Mirena coil was safe for use with HRT up to eight years.
I believed him and went on my way, glad I wouldn’t have to have my coil replaced for another three years.
I still felt uneasy about my overall experience with the second gynaecologist, though, and told my husband how his misogynistic comments and his dismissive nature of the first gynaecologist, plus his misinformation about when HRT patches needed changing, made me not want to see him again in three years time, and how I hoped I’d get a different in the future.
Fast forward a month, and I contact my GP to get prescribed some more HRT patches, as my current batch was due to run out.
The GP questioned me about the coil replacement, and I told her that the gynaecology consultant had said it was safe for eight years. She said this was new information to her, and that she would speak to her colleague (who is also the surgery owner) and confirm this. I was later called back by my GP, who said that she and her colleague had researched the situation, and that the use of a Mirena coil in conjunction with HRT was ‘unlicensed’. They recommended I have my coil replaced ASAP as a precaution, as not having an up-to-date coil while using estrogen patches can increase the risk of uterine cancer. I agreed.
But herein lies the problem. As I had the coil fitted at the hospital by the gynaecologist, I have to go through him to have it replaced. And my GP can’t send a new referral without directly contradicting him.
My GP is now trying to see if I can have my coil replaced elsewhere, but if I can’t, I may have to stop HRT before it’s even had a proper chance to get into my system (which can take 6-9 months) and have any effect on my PMDD symptoms.
Just to be doubly sure, I checked on the Mirena UK website, and it clearly states: To be used as part of hormone replacement therapy (HRT) for up to 4 years.
I feel so discouraged and frustrated. Both my GP and the first gynaecologist I spoke to have explained things in detail to me and have listened to my concerns. I feel like I have worked in partnership with them to come up with the best treatment plan.
I was happy with my treatment plan going forward.
And now all this has been overruled, and made 100 times more complex by a consultant whom I have no professional confidence in.
I emailed the hospital’s complaints department with my concerns, and already received an email back to let me know my complaint has been logged and will be investigated, so that’s reassuring.
But still… now I am in this limbo until I hear from my GP again, and regardless of the outcome, this whole situation — which, by the way, could have been avoided if the second gynaecologist had agreed to a procedure that should take an experienced doctor about five minutes — has left me feeling anxious, and uncertain about my PMDD treatment options going forward.
And I know I am not the only one. If he treated me like this, how many other patients have also received the same incorrect advice? And of course, this is just one doctor, in one hospital. Things like this are happening the world over.
I feel like health care — especially for cis women, trans men and nonbinary people — takes one step forward, and then 20 steps backwards.
I hope the situation improves for everyone, although with people in power like Trump, I won’t be holding my breath.
For now, I’m taking things one appointment at a time, trusting the doctors who do listen, and continuing to advocate for my own health — because no one else should have to fight this hard just to be heard.
If you’re navigating similar challenges, please know that your voice matters. You deserve evidence-based care, respect, and compassion — not dismissal. Keep pushing, keep questioning, and keep demanding better. We all deserve a healthcare system that listens.
