Generic v Brand name medications

***Warning graphic info regarding  my menstrual cycle***

Here in the UK we are very used to being prescribed generic rather than brand name medications. It is an easy way for the NHS to save money and I am all for that. I always felt somewhat bemused when I saw on forums people posting their complaints (normally in the USA) about their insurance companies only paying for generic medications after they had been on the brand name drugs. I was always under the impression that the generic versions of the brand name drugs were identical. Oh how very wrong I was.

A few months ago the contraceptive pill that I have been taking since around 2009 was suddenly changed to a generic version. I had been aware that the changeover was likely to happen as it had been mentioned on various UK forums that women had their prescriptions filled with this new contraceptive pill. When they had enquired with their doctors they had been told that C (how I will refer to the pill) was no longer in production and the new drug D was now being issued in its place. Apprised of the situation when my repeat prescription was filled with D, I made no enquiries myself figuring that I would be told the same as everyone else. If I was being given D instead of C I assumed it was the same thing just a different brand.

Initially there were no issues with the new contraceptive pill however after two months problems began to arise. After three months the side effects of the new contraceptive pill were unbearable. As I am too sick to visit the doctors at the moment (with visiting the physio as well I am exhausted also) and I felt it wasteful to request a home visit which I couldn't guarantee would be with my own doctor, I decided to write a letter. I find phone calls with my GP can be rushed purely down to my doctors workload. With a letter I could inform my doctor of all the problems I have been having so that he would be in a better position to help me. I have copied and pasted the letter below however some details have been edited to spare your blushes.

Dear Dr,

I am sorry to have to contact you via letter but it is probably better for me to give you more detail than can be given in a phone call, when I know that you are under enormous time constraints. I will give you fair warning that this is about my menstrual cycle, so if you are eating you may wish to finish before continuing!

Recently you changed my contraceptive pill from C to D . Unfortunately D has been an absolute nightmare. I am now having periods, which I haven't had since being on C. These periods are without giving you too much gory detail extremely painful. I am bleeding for around 10-12 days. When I have had periods in the past the longest I bled for was 5-7 days.

I am also noticing that I am having increased joint pain around the time of my period which would be down to the change in hormones, it is causing my tendons, ligaments etc to become more lax. The surge in hormones is also increasing my Dysautonomia symptoms and I am fainting and having more pre syncopal episodes now that the pill has been changed.

I have looked online and have seen no reports as to why my contraceptive pill has been changed from C which has worked effectively for me for many years. Please can you change me back to C? If this is not possible then I think I will need to see gynecologist. I do not want to have the contraceptive implant due to my poor healing and scarring (due to Ehlers Danlos Syndrome) and I also do not want to have the M Coil fitted as I find smear tests painful enough, without the added fun of trying to get a coil inserted.

My periods have been painful from the age of 11, they are not only painful but they cause me to vomit and have diarrhoea. As a child I was told that the pain would go away when I had a baby. Not very helpful when like me you have zero maternal instinct and sex is illegal at age 11. I have lost  days every month  from school, then university and then my workplace due to the agonising pain from my periods. It is embarrassing having to say to people they can't pop by and see you because you are stuck in bed with horrific period pains. It sounds like something from the dark ages.

I have tried lots of prescription painkillers over the years nothing worked, even on morphine my periods are still painful. The  pain goes through my buttocks, down  the backs of my legs and there is pain throughout my abdomen (basically belly button down). This pain happens all day and all night until the bleeding stops and can begin as many as three days before my period starts. Sometimes the pain is so intense it is contraction like and I can time them as come and go - usually 3 minutes apart. I have experienced a lot of pain in my life and period pain is the worst pain I have experienced by far. Purely because of its duration and the fact it is unrelenting.

This new pill is making my moods swing, I am tearful one minute and angry the next. Its like I have PMT all day everyday. I feel like I am having a bout of the blues, it's not depression but I feel like I can't be bothered with anything and feel great sadness. I worry that continuing with this pill will lead me into a depressive episode which I really don't want.  

I have sore breasts for two weeks out of the month. They are so sore I can't even stand someone brushing up against me by accident or wear a bra. To be blunt this new pill is making my life a misery.

If I can't have C on prescription then something has to be done about my periods. I know painful periods are part of Ehlers Danlos Syndrome but I am not prepared to put up with the pain when it is not medically necessary. As I have said to you before I will jump for joy the minute any doctor tells me I can have a hysterectomy as I am sick to the back teeth of my uterus. This probably seems melodramatic but I assure you I am not kidding. I really can't stand this.

I had to write to you rather than book an appointment as it would take at least 20 minutes for me to stop crying when I started talking to you. This new pill has me on the verge of depression. I am starting to question whether it is the pill or if I have started the menopause? I know my days of being on the contraceptive pill are numbered due to my age. So something will have to be done now or in a few years regardless. Sorry to have rambled on but I wanted to put you in the picture of why I want / need  to be put back on C.

Thank you for listening.

My doctor rang me the day he received my letter, I wasn't expecting such a prompt response. He told me was very sorry that I had been having such a torrid time of it since being placed on D. He informed me that D was the generic version of C and theoretically shouldn't make such a difference but he was well aware that some people do find generic versions of brand name medications produced side effects that were not present when using the brand name. C's production had not been stopped but doctors are advised to issue the generic medication wherever possible, a prescription for C would be at the pharmacy the next day for me and my notes would be amended to show that I must be prescribed C not D in future. He told me that he would probably get into some trouble for prescribing C instead of the generic version however he had two pages of reasons why I couldn't be prescribed the generic version thanks to my letter.

I was so happy I could have cried when he told me that C was still in production and that I could have it. I had been an absolute mess on the generic version. I have been back on C for just under two weeks and the difference is amazing. I feel like me again, the sadness has gone, my joint pain is back to its normal level. I just feel more human again and hubby is no longer getting his head bitten off at every available opportunity. Having just chatted to him about my blog post he told me he can't believe the difference in me already. 

Before I experienced the issue with having a generic medication instead of the brand name I never gave the complaints on forums much credence. I like many other people assumed that generic meant the same. I know now that it was a huge mistake I am just really pleased that my own doctor appreciates that some people need the brand name medication. I was lucky but what about those patients who aren't?

I didn't get my request for a hysterectomy, I will keep trying for that one. I even offered to donate my uterus for transplant to someone who wants a child - like the stories that have been on the news recently. My doctor told me that our part of the country isn't set up for that yet. I will be at the front of the donations list when it is. As I stated in my letter I really am sick to the back teeth of my uterus and all the problems it has caused me for the last 30 years.

I do get angry when menstrual problems aren't taken seriously. I really do believe that if men had periods the situation would be oh so different. Even women doctors can be dismissive of the issue if they have never experienced the discomfort of bad menstrual cramps. It is a serious issue for many women and I sincerely hope any young girls who are having issues aren't given the advice that I was 30 years ago that having a baby will solve the problem. Given my family history, I can tell you that even after the women in my family have given birth they still have horrific period pains.

I know given my status as a barren old maid well not quite, it's actually mine and hubby's choice not to procreate, the menopause fairy should be visiting me early. It is something that fills me with dread because again female family history is not on my side with that one either.

Oh the joys of being a woman!