The practice offers a full range of contraceptive options for free in surgery so please book an appointment with the practice nurse or GP/NP to discuss this. We fit coils and implants, and advise you to book an appointment to discuss this first with Dr Menon or Dr McCrone who fit these. If you are booking an implant re-fit you can book this directly with reception. We also offer emergency contraception, please let reception know it is urgent.
Coil insertion (copper = non hormonal or hormone releasing such as Mirena)
The procedure requires vaginal examination – similar to when you have a smear or swabs taken. We do use a local anaesthetic, either in a form of gel or spray.
The risks of the actual procedure are:
Infection (typically within the first 3 weeks);
Bleeding – small bleeding after procedure, change to your bleeding pattern;
Perforation (causing a tear inside the womb) – this is rare (2 per 1000 insertions);
Expulsion – meaning that your body will try to push the coil out. In this case, please use another form of contraception such as condom and book an appointment with a clinician;
Ectopic pregnancy – this means pregnancy outside of the womb, which is very rare
as the overall risk of pregnancy is very low;
If you are having a coil inserted for the first time, it is important that there is no chance of you being pregnant. Please, ensure that you do not have an unprotected sexual intercourse from your last period and continue to use your current form of contraception. You might be asked to continue with your current form of contraceptive method until after your coil insertion.
After your coil insertion, it is normal to have some cramping, period like pains, however these should not be severe. Simple pain relief should normally suffice. There could be some bleeding afterwards, but it is unusual for this to be very heavy.
You may be advised to avoid sexual intercourse, swimming, and the use of tampons for one week after your coil insertion. This is to reduce the risk of infection.
You will have plenty of time to ask any questions you may have on the day of your appointment. If you are not sure about which type of coil you would like, please do discuss this with one of the clinicians first.
Coil change – copper or hormone releasing such as Mirena
All above also applies when you already have a coil and you are having this changed. In this case, it is however also important that you do not have unprotected sexual intercourse (without other form of contraception such as condom) for one week before your appointment.
Occasionally, when old coil is removed, it is not always possible to re insert the new one as the neck of the womb does not allow this. If you were sexually active without extra protection, during the week before your change, and new coil cannot be inserted at the same time, there is a theoretical risk of you falling pregnant.
What is the contraceptive implant?
· The contraceptive implant is a small plastic rod, around 4 cm long, that the GP or nurse puts under the skin of your arm.
· It prevents pregnancy by releasing the hormone progestogen. This stops the ovaries releasing an egg each month.
· The implant works for 3 years before it needs to be replaced. It is over 99% effective.
· A GP or nurse can remove the implant at any time if you no longer want to use it.
· Once the implant is removed your chance of getting pregnant will return to what it was before the implant was fitted straight away.
· The implant does not stop you getting or passing on sexually transmitted infections (STIs). Use a condom every time you have sex to protect you and your partner against STIs, including HIV.
Pregnancy and breastfeeding
· You can have the contraceptive implant fitted any time after you’ve given birth. The implant is safe to use while breastfeeding and will not affect your baby or milk supply.
· If you’ve had a miscarriage or abortion, you can have the contraceptive implant fitted as soon as you want to.
Medicines and the contraceptive implant
· Some medicines and herbal remedies can affect how the contraceptive implant works. It may not work properly to stop you getting pregnant.
· Ask a doctor or pharmacist before having a contraceptive implant fitted if you take medicine to treat TB (tuberculosis), epilepsy or HIV.
· You should also ask for advice if you take griseofulvin (an antifungal medicine), or St John’s wort (a herbal remedy).
Having the contraceptive implant fitted/removed
The nurse or doctor will:
· use a local anaesthetic injection or spray so you will not feel pain
· make a small cut in the skin of your upper arm
· put the implant under your skin – it’s about the size of a matchstick and will not be visible once fitted
· seal the cut with a dressing, which you can remove once the cut has healed
· You can ask for the contraceptive implant to be removed at any time. Getting the implant removed is very similar to having it put in. A GP or nurse will use a local anaesthetic for pain relief. A small cut is made in your arm, the implant is removed and the cut is sealed with a dressing.
Side effects/Risks
The contraceptive implant is very safe and serious side effects and complications are rare.
It’s very common to have a change in your periods after you have an implant fitted.
You may notice your periods:
· are lighter
· are less regular with light bleeding (spotting) between periods
· are heavier or more painful
· last longer
· stop completely
· It’s also possible for your periods to become more unpredictable, for example having a heavy period followed by a very light period, or missing a period.
These changes are not usually anything to worry about, but if they become a problem for you contact a GP or sexual health clinic.
Other reported side effects of the contraceptive implant include headache, sore breasts, acne, and the evidence is too limited to confirm a possible link with depression.
The contraceptive implant is very safe, but there are some risks including:
· infection where implant is put in – this can lead to swelling and pain at the site of the implant
· the implant moving out of place, usually a few centimetres away from where it was put in
Rarer, more serious risks include:
· a very small increase in the risk of breast cancer
How Do I Book An Appointment?
· Please speak to reception and ask for an appointment with Dr Menon or Dr McCrone to discuss having an implant fitted, this can be a phone call.
· If you need your implant replacing or removing, you can book directly for an ‘implant appointment’ via reception. This will allow reception to book you with the correct doctor/nurse and allow enough time.