Cases for Women’s Health

39y. PMH: nil. DH: COCP

I’m worried because my sister has just been diagnosed with breast cancer. Do I need a referral because of my family history?

Sister is 44

No other family history of any cancers

No Jewish heritage

ICE: COCP – I’ve heard it can increase breast cancer risk? Should I stop it?

Should I get one of those private screening tests just to be safe?

When can I get a mammogram?

How can I reduce my risk?

28y. PMH: nil. DH: COCP

I was sent for an USS by the other doctor and I’ve seen in my NHS app that it is normal. Does that mean there’s nothing wrong?

Always had heavy painful periods since menarche (age 13) but now pelvic pain too for the last 18/12

Pain is worse a week before periods start

Loose and bloody bowel motions the week prior to and at start of period

Dyspareunia

Really struggling with work – having to take about a week off every month and getting in trouble

Struggling with relationship with partner due to painful sex

Struggling with mood due to all of the above

Embarrassing episodes of flooding and spending £££ on sanitary wear

Want to TTC soon

Not tried anything except paracetamol yet

ICE: Would like a diagnosis, could it be endometriosis?

Worried about impact on fertility

Should she get referred?

If pain and bleeding could be managed as well as any suggestions for work – happy to try

30y. PMH: hypothyroidism. DH: levothyroxine 50mcg

Yes this pregnancy was planned

LMP makes her around 6 weeks (regular periods)

This is my first pregnancy

Has not contacted CMW yet

Made GP appointment as mother in law told her that’s what you have to do, is it not?

Not taking any pre-natal vitamins yet

Has annual TFTs and has been stable on thyroxine dose for several years

ICE: How can I best stay healthy, anxious about pregnancy given thyroid problem

Will the baby have thyroid problems too?

32y. PMH: nil. DH: recent acutes – cyclizine, prochlorperazine

The new tablets still aren’t working

I’m now 8 weeks and still struggling with nausea. I’m not vomiting much.

I’m a nurse and really struggling at work.

I am eating small, bland foods and drinking fluids but not tolerating larger meals

I’ve tried two medications now and I’m worried because the last GP told me that if this one didn’t work there’s not really anything else to try

You don’t really want to be off work

You have been checking your urine at work for ketones.

ICE: Is there really nothing else I can try? When will this stop?!

23y. PMH: migraine.

My periods are so irregular

Menarche aged 14, settled into a semi-regular pattern but then for the last 2 years or so have been all over the place

I think I probably have a period every 12-16 weeks, I think I had 3 periods last year

No IMB or PCB

Not currently sexually active, not planning to become pregnant, not had intercourse

Significant acne and hirsutism

BMI normal

I have migraine with aura

ICE: Older sister had similar and was told had PCOS after USS – will I have to have one? Worried re: TVUSS

I also googled PCOS and it looks like COCP is recommended – can I try that? Worried about risk of endometrial hyperplasia. Would not want coil as not sexually active.

50y. PMH: anxiety. DH: sertraline

Sorry to bother you, I know you’re busy, I was hoping to get a blood test first and then come to you if needed. But your receptionists, they really gatekeep don’t they, wow

I wanted the blood test to see if I’m menopausal or not, there was an article about it online

Periods have become more erratic and heavier last 6/12 or so

Feeling much more irritable, snapping around husband and children

Really feeling like I can’t function at work and that’s not an option, I work as a regional manager so have a lot of responsibility

Low libido and dry down below

Flushes and poor sleep at night

Thought you needed a blood test, is that not the case?

On sertraline but I don’t think this feels the same as what I started that for

Not had a hysterectomy, had 2x children NVD 20/25 years ago

Not using any hormonal contraception, rarely have sex – I’m too old to get pregnant now??

ICE: Open to HRT, aware of risks and benefits

74y. PMH: polymyalgia. DH: prednisolone

I don’t see what all the fuss is about, I spent long enough waiting at that hospital

It’s only a little break to the wrist, nothing I can’t handle

Fell putting the washing out tripped over dog, standing height

Neighbour saw and made go to A&E, what a fuss

No previous falls

Non-smoker, partial to a sherry most evenings

I take these steroids for that Polymyalgia, marvellous things they are don’t you ever take them off me

Menopause donkeys years ago (at age 40 when pressed)

Live alone, fiercely independent, want it to stay that way. Neighbour keeps an eye, sons miles away in Australia but they do call, guilt calls I call it

Never had a bone scan

Not under rheum for PMR just GP and been on steroids for ages

Diet is ok, not much fun cooking for one so mainly just have ready meals

ICE: don’t understand why have been called back by GP, don’t want a fuss, does NOT want to stop prednisolone

68y. PMH: recurrent UTIs. DH: recent acutes – 5x prescriptions for nitrofurantoin in last 3 months

I tried to request some more antibiotics because my symptoms haven’t gone away this time but reception said it had been declined. I don’t see why, I got them this way in the past?

I get recurrent UTIs, I always get antibiotics. Sometimes it settles it sometimes it doesn’t…if I’m honest usually it doesn’t. Maybe it’s more that the symptoms go away for a bit then come back.

Also had some from the pharmacy and from the OOH GP

Also tried some thrush treatment to see if that helped but it didn’t

Burning/stinging sensation down below, worse when PU, but the sensation is there even when not PU

No suprapubic pain or flank pain

No fevers, no vomiting

Feeling like need to PU all the time

Aren’t these symptoms of UTI? My friend has the same issue, her GP just gives her the antibiotics

If I think back probably have felt these symptoms for months if not years.

Just assumed it was part of getting older

Menopause – around 55, did not have HRT as symptoms weren’t too bad

If asked yes is affecting sex life, pretty much don’t have intercourse any more as too painful

No bleeding no discharge, regular sexual partner (husband)

ICE: annoyed script for antibiotics was rejected, normally it’s not a problem I don’t see what the fuss is about. Open to discussing topical oestrogen if offered, anything to help the symptoms. Will that stop me getting UTIs??

Page last reviewed: 2 June, 2026