Period Pain Prescription

Start Your Consultation

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Do you agree and consent to the following?

You are completing this consultation for yourself and to the best of your knowledge.
You will disclose any medical conditions, serious illnesses or operations you have had.
You will disclose any prescription medications you are currently taking and agree to use only one weight loss treatment at a time.
You agree to our Terms & Conditions, Terms of Sale, and confirm that you have read our Privacy Policy.
Your accurate and honest responses to this online questionnaire for weight loss treatment are crucial. Withholding or providing false information can severely harm your health and may result in life-threatening consequences. By filling out this questionnaire, you confirm that your responses are truthful and accurate, acknowledging the potential risks of misinformation.
You agree to undergo identification and age verification. This may require submitting valid documents to our approved third-party verification partner for validation.
You consent to EveryDayMeds accessing your Summary Care Record (SCR) for the purpose of ensuring the safe supply of treatment. If the SCR is unavailable or incomplete, you agree to participate in appropriate two-way communication (e.g. phone, secure message, or video consultation) to verify your medical history. If you do not respond or engage, your order will be cancelled.

Your Health

Are you biologically female?

Female Male Trans Female (Male at birth) Trans Male (Female at birth)

Are you currently pregnant, planning to become pregnant, or breastfeeding?

Yes No

Are you over 65 years old?

Yes No

Do you have a known allergy or intolerance to any medications or substances?

Yes No

Please select your allergies or intolerances:

Nuts

Soya

Lactose

Medical Condition

Have you always experienced period pain since your periods began?

Yes No

Does your pain completely disappear once your period ends?

Yes No

Do you experience any of the following symptoms?

Pain during sex Bleeding during or after sex Abdominal swelling that doesn’t go away Heavy periods Spotting between periods None of the above

Have any of your menstrual symptoms changed recently?

Yes No

Please describe how your symptoms have changed.

Have you had an IUD (coil) fitted in the last 6 months?

Yes No

Has your pain worsened since the coil was fitted?

Yes No

Have you spoken to your GP about your painful periods?

Yes No

What did your doctor advise about the cause of your symptoms?

Medication

Are you currently taking any medication (prescription, over-the-counter, or recreational drugs)?

Yes No

Please list the medications you are currently taking:

Have you been told you have a hiatus hernia?

Yes No

Are you taking medication for your hernia?

Yes No

Do you still experience symptoms from your hernia?

Yes No

Please describe the symptoms and how often they occur:

Do any of the following medical conditions apply to you?

Gut problems (e.g. ulcers, Crohn’s, or colitis)

Asthma

Blood clotting disorder

Liver or kidney problems

None of these

Do any of the following lifestyle factors apply to you?

You smoke

You drink alcohol on more than 3 nights a week

None of these

Do you have or have you ever had any of the following?

Heart attack or stroke

Heart failure

High blood pressure

Systemic Lupus Erythematosus (SLE)

None of these

Are you currently taking any of the following medications?

SSRIs (e.g. Fluoxetine, Citalopram)

Oral corticosteroids (e.g. Prednisolone)

Anticoagulants (e.g. Warfarin)

Clopidogrel

Regular aspirin

Other NSAIDs (e.g. Ibuprofen, Mefenamic Acid)

Methotrexate

Lithium

None of these

Are you taking any of these medications?

Blood pressure medicines

Diuretics (e.g. Furosemide)

Digoxin

Ciclosporin or Tacrolimus

Diabetes medication (e.g. Gliclazide)

Quinolone antibiotics (e.g. Ciprofloxacin)

Probenecid

Hydantoins (e.g. Phenytoin)

HIV medications

Colestyramine

None of these

Agreement

Please confirm the following:

I will read the patient information leaflet supplied with my medication.
I will inform my GP and this service if I experience side effects, start new medication, or if my health changes.
This treatment is for my personal use only.
I have answered all questions truthfully and understand that prescribers base decisions on these answers.

Yes No

Do you give us permission to access your NHS Summary Care Record or request medical history from your GP if required?

Yes No

Do you consent to us sharing relevant consultation details with your GP to ensure continuity of care?

Yes No

GP Consultation

We can notify your GP of your treatment for you. To do so, we need their contact information. Sharing this information allows your GP to maintain a comprehensive record of your medical history, which is crucial for your health. Without complete records, there could be potential risks to your well-being.

I consent to EveryDayMeds contacting my GP and share information about my prescription.

Yes No

Practice/GP Name

Practice/GP Address

Identity Verification

Please upload your identification documents.

Would you like to upload documents now?

Upload now Upload later

What you need to upload

To safely prescribe weight-loss medication, our clinicians need to verify your identity and assess your eligibility. Please upload both of the following:

Photo ID

Upload a clear photo of one valid ID document, such as:

Passport
UK driving licence
National ID card

Requirements:

The full document must be visible
Text and photo must be clear and readable
The ID must be valid (not expired)

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Tap to upload ID card

No file chosen

Full-Body Photo

Take a full-body photo of yourself using your camera.

Photo guidelines:

Full body visible (head to feet)
Wear fitted clothing (no coats or baggy clothes)
Stand straight, facing the camera
No filters or edits

This photo is used only to help our clinicians assess your BMI and suitability for treatment.

📸

Take photo using camera

Camera required

Upload Previous Prescription

📄

Upload previous prescription

No file chosen

If you select this option, your order won’t be approved until all required documents are submitted. After your consultation, we’ll email you instructions on how to upload your documents.

Your Period Pain Prescription Plan

Mefenamic Acid 500mg - 28 Tablets

£49.99

Naproxen 250mg

£9.99

Quantity

Naproxen 500mg - 28 Tablets

£9.99

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