Family Planning/ Contraception 

Family Planning (FP) is having the desired number of children and when you want to have them by using safe methods.

We run family planning clinics for our patients. This includes contraception advise and administration of various contraceptive methods.

Please contact us if you need further information or support with family planning. Please see the link below for further information on family planning methods.

Contraception Guide – nhs.uk
Vasectomy Service

Your Contraception Choices

For more information on your contraception choices, please see one of the links

Contraception choices
Which method of contraception suits me?

Contraception Choices

Most women are comfortable and familiar with using the Pill, though this is not always the most reliable method. Other methods known as LARCs or Long Acting Reversible Contraception can protect you for weeks or months at a time without you having to remember to do anything. 

You and your health provider can talk about the best contraception for you.

The following is a brief description of all of your contraception choices.

The male condom

The male condom is a fine rubber or synthetic sheath that is worn on a stiff (erect) penis. It collects the sperm and stops them entering your vagina and uterus.

You can buy condoms from a chemist or supermarket. Condoms reduce the risk of both pregnancy and sexually transmitted infection. Condoms are 98 per cent effective if they are used correctly.

Diaphragms

A diaphragm is a soft silicone cap worn inside the vagina to cover the entrance to the uterus (the cervix). It stops the sperm from getting into the uterus. A diaphragm can be used at any time, even during your period, and can be washed and used over and over again.

A diaphragm has to be put in before having sex (up to 24 hours before) and removed after sex. When used correctly diaphragms are 94 per cent effective at preventing pregnancy.

The Pill

Even though we use the expression ‘the Pill’, there are actually two main types of oral contraceptive pills.

The combined pill

This pill has two hormones, which stop the ovaries releasing an egg each month. You still bleed each month but not as much as usual.

The combined pill can also bring relief for acne and premenstrual syndrome. Some women will have side-effects such as bloating, nausea, and minor weight gain. The combined pill is 99.7 per cent effective with perfect use.

The progestogen-only pill (mini pill or POP)

This pill has only one hormone and works by changing the mucus at the entrance to the womb (uterus) so that sperm cannot pass through to fertilise the egg.

The progestogen-only pill is different to the combined pill because it doesn’t stop ovulation. The POP is 99.7 per cent effective with perfect use.

If mistakes happen, such as missed pills, around one in ten women may get pregnant.

The vaginal ring

The vaginal ring contains the same two hormones that are in some types of the Pill. It works in the same way as the Pill to prevent an egg being released each month. The ring is placed high in the vagina and left in place for three weeks.

It is removed for one week to allow you to have a regular monthly bleed. The vaginal ring is 99.7 per cent effective with perfect use. Like the Pill, 1 in 10 women (10 per cent) using a vaginal ring may get pregnant.

Emergency pill

(Sometimes called the ‘morning after pill’)

If you had sex without contraception, or you were using a condom that broke, you can take an emergency pill, which will prevent a pregnancy from happening.

Emergency pills are available from the chemist with no prescription. They must be started within three days (72 hours) after unprotected sex and they work best if taken as soon as possible after sex.

The contraceptive injection

DMPA (also called Depo Provera or Depo Ralovera) is an injection of a long-acting synthetic hormone. Women have the injection every 12 weeks for contraception. It can be used when breastfeeding. Some women will have side-effects, such as mood changes, tummy discomfort and headaches, which can last for up to 12 weeks. Depo Provera is 99.8 per cent effective with perfect use.

Contraceptive skin implant

This is a small plastic rod, which is inserted underneath the skin on the inside of the upper arm. It slowly releases the synthetic hormone progestogen, which stops the ovaries releasing an egg each month. Most women will have a different bleeding pattern and some stop bleeding altogether. Some women will notice skin changes, mood changes or minor weight gain.

It will last for three years and is a very effective method for preventing pregnancy (99.95 per cent effective).

Intra Uterine Device (IUD)

This is a small contraceptive device that is placed in your uterus.

There are two kinds of IUD:

  • copper IUD  – lasts five to ten years and is 99.4 per cent effective
  • progestogen IUD – lasts for five years and is 99.8 per cent effective.

The IUD affects sperm movement and survival in the uterus (womb) so that they cannot reach the egg to fertilise it. The IUD also changes the lining of the womb (endometrium) so that it is not suitable for pregnancy. This prevents a fertilised egg from developing.

It is very effective long-term contraception.

Sterilisation

Both men and women can have an operation to make them sterile. The woman’s operation involves blocking the fallopian tubes. It is done through the abdomen and is called a tubal occlusion and tubal ligation. The male operation is called a vasectomy. The operations are more than 99 per cent effective and are permanent. This method is for people who have already had all the children they want.

There are also now tiny inserts that can be placed inside a woman’s tubes by means of a special instrument. This procedure is done through the vagina and can be done while the woman is awake.

Natural methods of contraception

The rhythm or Billings methods, fertility awareness, mucus, ovulation and temperature methods all provide ways for your to monitor where you are at in your cycle and when you are fertile. These methods are most effective when you have regular periods.

If they are done perfectly these methods are between 95 to 99.6 per cent effective. However, 5 in 20 women (25 per cent) may get pregnant using these methods.

Withdrawal

This is when the man takes his penis out of the vagina before he ejaculates and sperm is released from the penis. This doesn’t work if he forgets to withdraw his penis or is not quick enough. Also there may be some sperm in the pre-ejaculate (fluid that comes out of his penis before he ejaculates). If he ejaculates at the entrance to the vagina some sperm may still swim inside and a woman could still get pregnant with this method.

Perfect use of the withdrawal method is 96 per cent effective. Approximately 2 in 10 women get pregnant using this method of contraception.

Intrauterine Contraceptive Device (IUCD)

https://www.youtube.com/watch?v=XHRYE2FsXmc

Mirena (Coil) Information

The Intra-Uterine System (IUS) ‘Mirena Coil’ Patient Information
This section aims to answer your questions about the intra uterine system (IUS), known as Mirena. It explains the benefits, risks and alternatives, as well as what to expect when you come to the surgery.

What is the IUS?
The Mirena IUS is a small plastic T-shaped device containing progestogen hormone (levonorgestrel).

It is fitted into the womb where the hormone is released slowly over 5 years. It has two fine threads that come through the cervix (neck of the womb) opening and rest at the top of the vagina, in order to be checked and removed when necessary.
There are alternate IUS devices available in the practice, which you may wish to discuss.

What is the IUS used for and what are the benefits?
Long term contraception
The Mirena is widely used as a long term reversible contraceptive and can be left in place for up to five years (or longer if you are over the age of 45). It is one of the best forms of contraception, with only two in 1,000 women getting pregnant (0.2%)
However, should you wish to get pregnant, fertility returns to Normal when the Mirena is removed.

Heavy, painful periods
It is used as a treatment for heavy periods and can reduce period bleeding by up to 90%. In addition, up to 50% of women will have no periods after one year of use.

The Mirena coil has been successfully used to reduce period pains and is a known treatment for conditions such as endometriosis.

HRT
It can be used as part of HRT to provide womb lining protection. Most benefits of HRT come from oestrogen, however, if given alone, it causes thickening of the lining of the womb leading to irregular bleeding and other problem.

Many women are unaware that they may still need contraception even if they are taking HRT (this should be discussed with your GP). A further advantage is that the Mirena coil is the only ‘progesterone part’ of HRT that can double up as contraception.

Avoiding surgery
It is much safer to insert a Mirena than to have surgery for heavy periods, or a sterilisation for contraception.

Medication interaction
The Mirena coil is not affected by other medicines and is safe to use whilst breastfeeding.

What are the risks?

Difficulty with insertion
Occasionally, there can be difficulties for example if your cervix is tightly closed. This is more common in those who have had surgery to the cervix, or not had children vaginally. Your doctor may be able use equipment to help open the cervix. If this is not possible you may need to be referred to the hospital to have it fitted.

Perforation
Rarely, the Mirena coil might go through the wall of the womb. This risk may be higher if breastfeeding. One sign maybe pain, but often there are no symptoms and the womb will heal by itself.

Expulsion
Rarely, the Mirena may be pushed out of the womb or displaced. Your nurse will teach you how to check your threads are in the correct place, which you should do every few months.

Infection
There’s a small chance of getting a pelvic infection during the first few weeks after an IUS is put in.

Ectopic pregnancy
The Mirena is very effective and it is unlikely you’ll get pregnant. If you do, there’s a small increased risk of it developing outside the womb.

Are there side effects?
Side effects are more common within the first few months and generally settle after continued use.

Hormonal
These may include breast tenderness, headaches, acne and symptoms similar to PMS.

Bleeding problems
Some women may experience changes to their bleeding patterns. This usually settles by 3-6 months. We encourage you persevere and speak to your GP if you find this difficult.

Ovarian cysts
Occasionally, women may develop functional or simple ovarian cysts (small fluid filled sacs on the ovaries), which are not dangerous. They usually cause no symptoms and go away on their own.

Am I suitable for the Mirena Coil?
There are some women for whom the IUS is not suitable. This will be assessed at the time of counselling.

In particular, please inform us if you have any of the following:
– allergy to progesterone/levonorgestrel
– suspected pregnancy
– unexplained vaginal bleeding
– pelvic inflammatory disease (current or within the last three months)
– changes to the shape of the womb.

How can I prepare for having an IUS fitted?
Timing of fitting
An IUS can be put in at any time in your menstrual cycle. If fitted in the first seven days of your menstrual cycle, you do not require any further contraception. If fitted at any other time, you will need  additional contraception for the first seven days.

Ensuring you are not pregnant
Prior to having your IUS fitted, you will need to ensure you use adequate, reliable contraception or do not have sexual intercourse from your last period. Please inform us if there is a possibility you are pregnant.

Previous infections
Your nurse will check if you are at risk of infections including previous sexually transmitted infections or a new partner within the last 12 months. We may recommend you have a sexual health screen/ vaginal swabs prior to/at the time of your coil fitting.

Heart conditions
Tell your nurse/doctor if you have an abnormal heart valve, as you might need antibiotics to cover the insertion procedure.

Pain relief
You may feel pain during and after the fitting. We would suggest that you take some painkillers about an hour before you have the IUS fitted.

Contraception
It is important to have prior alternate contraception arranged in case the device cannot be fitted.

What happens during the IUS fitting?
Your appointment will last 20–30 minutes. We will check that you have understood all the information provided and you will be asked to sign a consent form. The doctor will examine you internally to check the position and size of your uterus before inserting your coil. You may be offered swabs/a smear at the same time.

Before you leave, you will see the nurse and be given an aftercare leaflet. You may want to bring a chaperone as some women experience cramps and slight bleeding after the procedure.
If you have any further questions, please phone the surgery to arrange a telephone consultation with the well woman nurse or your own GP.

The Intra-Uterine Coil Device (IUCD) ‘Copper coil’ Patient Information
This section aims to answer your questions about having the Intra Uterine Coil Device (IUCD). It explains the benefits, risks and alternatives, as well as what you can expect when you come to the surgery.

What is the IUCD?
The intra uterine system is a small plastic T-shaped copper device that is fitted into the womb to prevent pregnancy. It does not contain any hormones. It has one or two very fine threads that come through the cervix (neck of the womb) opening and rest at the top of the vagina, so that it can be checked and removed when necessary.

What is the IUCD used for and what are the benefits?
Emergency contraception
The IUCD is the most effective emergency contraceptive option (if suitable),and can be kept in the uterus to be continued as long term contraception.

Long term contraception
The IUCD is widely used as a long term reversible contraceptive. There are different types and sizes, which can be left in place for up to five or 10 years (or until after menopause if you are over the age of 40). It is one of the best forms of contraception, with only two in 100 women getting pregnant (2%)

It works by: preventing sperm from surviving; altering cervical mucus to prevent sperm from reaching an egg; and preventing an egg implanting in the womb.
However, should you wish to get pregnant, fertility returns to normal when the coil is removed.

Avoiding surgery
It is much safer to insert an IUCD than to have surgery for sterilisation.

Medication interaction
The IUCD is not affected by other medicines and is safe to use whilst breastfeeding.

What are the risks?
Difficulty with insertion
Occasionally, there can be difficulties for example if your cervix is tightly closed. This is more common in those who have had surgery to the cervix, or not had children vaginally. Your doctor may be able use equipment to help open the cervix. If this is not possible you may need to be referred to the hospital to have it fitted.

Perforation
Rarely, the IUCD might go through the wall of the womb. This risk may be higher if breastfeeding. One sign maybe pain, but often there are no symptoms and the womb will heal by itself.

Expulsion
Rarely, the IUCD may be pushed out of the womb or displaced. Your nurse will teach you how to check your threads are in the correct place, which you should do every few months.

Infection
There’s a small chance of getting a pelvic infection in the first few weeks after an IUCD is put in.

Ectopic pregnancy
The IUCD is very effective and it is unlikely you’ll get pregnant. If you do, there’s a small increased risk of it developing outside the womb.

What are the side effects?
Bleeding problems
Some women may experience heavier, longer, or more painful periods. This may improve after a few months. It is important that you are aware of this risk and speak to the nurse or GP before consenting for this procedure. They may be able to suggest other, more suitable intra uterine contraception such as the Mirena coil.

Am I suitable for the IUCD?
There are some women for whom the IUCD is not suitable. This will be assessed at the time of counselling.

In particular, inform us if you have any of the following:
– allergy to copper
– suspected pregnancy
– unexplained vaginal bleeding
– pelvic inflammatory disease (current or within the last three months)
changes to the shape of the womb.

How can I prepare for having an IUCD fitted?
Timing of fitting
An IUCD can be put in at any time in your menstrual cycle. It is effective immediately.

Ensuring you are not pregnant
The IUCD can be used as emergency contraception if you have had unprotected sexual intercourse in the past 5 days (or up to 5 days after the earliest time of ovulation). It can then be kept in to use for long term contraception.

However, multiple episodes of intercourse or episodes outside of this window can result in pregnancy. Therefore, prior to having your IUCD fitted, we strongly advise you ensure you use adequate, reliable contraception or do not have sexual intercourse from your last period.

Previous infections
Your nurse will check if you are at risk of infections including previous sexually transmitted infections or a new partner within the last 12 months. We may recommend you have a sexual health screen/ vaginal swabs prior to/at the time of your coil fitting.

Heart conditions
Tell your nurse/doctor if you have an abnormal heart valve, as you might need antibiotics to cover the insertion procedure.

Pain relief
You may feel pain during and after the fitting. We would suggest that you take some painkillers about an hour before you have the IUCD fitted.

Contraception
It is important that you have prior alternate contraception arranged in case your device cannot be fitted.

What happens during the IUCD fitting?
Your appointment will last 20–30 minutes. We will check that you have understood all the information provided and you will be asked to sign a consent form.

The doctor will examine you internally to check the position and size of your uterus before inserting your coil.

You may be offered swabs/a smear at the same time if this has already been discussed.
Before you leave, the nurse will check any further questions and give you an aftercare leaflet. You may want to bring a chaperone as some women experience cramps and slight bleeding after the procedure.
PLEASE NOTE – YOU MUST TELL THE RECEPTION STAFF THAT YOU ARE BOOKING A COIL (IUD) FITTING. 

When to book your fitting:
 
While they can be fitted at any point in your cycle, IUD or IUS insertion is best done towards the end of your period. This is because we can be sure you are not pregnant at this time, and also the fitting itself is more comfortable for you, as the neck of the womb is a little more “open”. 

A few days after the end of your period is fine, but if you are using Condoms, a Diaphragm, “natural methods” including Persona, or having Unprotected Sex, between the first day of your period and the day of your fitting, you MUST abstain altogether from sexual intercourse.  These methods should not be used, no matter how careful you are.
 
This advice is necessary because we need to be certain that at the time the IUD or IUS is fitted, you are not in the very early stages of pregnancy nor are there any sperm in your body, which could result in a pregnancy.
 
If you are using a hormonal method (the Combined Contraceptive Pill, Progesterone-Only-Pill, injection method or implant), the IUD or IUS can be fitted at any convenient time, as long as you are not bleeding too heavily.
 
If you are having an IUD or IUS removed and a new one fitted, this can be done on any day except a day of heavy bleeding. You should not have sexual intercourse for the seven days before the fitting. This is to ensure that there is no sperm in your body that could result in a pregnancy, if it is not possible to fit a new device after the original one is removed.
 
Our administrative staff or Health Care Assistant Advance book your appointment but cannot give contraceptive advice. If you are not sure about when to book your appointment, or which contraceptive method to choose, please discuss this with one of our clinicians.

Use this link to view a video for further information:
 
https://www.youtube.com/watch?v=XHRYE2FsXmc
 
On the day of the fitting:
 
– Do not skip a meal – it is best to have eaten prior to the fitting
 
– Please write down and bring the start date of your last period to the fitting
 
– It is sensible to take a “pain-killer” at least half an hour before the fitting, to reduce cramps afterwards eg. Paracetamol 1g or Ibuprofen (neurofen) 400mg.
 
– Please allow at least an hour for the appointment. Although the procedure does not take this long, a few women may feel faint afterwards and need time to recover. It is recommended that you have someone you can contact by phone, who would be able to collect you, in case you feel unwell.
 
– Please ensure that you have no major commitments afterwards, as you may need to take it easy and relax for the rest of the day.
 
– Do not bring small children or babies with you to the fitting, or alternatively please bring a friend with you who could take care of them outside the room.
 
– Some sanitary protection may be required afterwards. You may wish to bring your own sanitary towel or panty liner with you. Tampons should not be used for the first three days after the fitting.
 
PREPARING FOR THE INSERTION OF AN
INTRAUTERINE DEVICE (COPPER IUD) OR AN INTRAUTERINE SYSTEM (MIRENA)
 
We are keen to make your coil fitting as straightforward as possible. It is important that you have read all the information and are suitable for the procedure on the day you come.    

Please bring this form with you when you attend the surgery for your coil fitting.
 
Please tick the boxes to confirm that you have understood and agreed to the following:
I have accessed online information on IUD/IUS or read the leaflets or I already have an IUD/IUS and am familiar with the method.

I am using an effective method of contraception and haven’t had any problems (e.g burst condom, missed pills, IUD overdue for change). I have not had unprotected sex (or used withdrawal) since my last period. I understand that it is not safe to insert an IUD/IUS if I might be pregnant.

I will make sure that I have had breakfast/lunch on the day of the appointment. A painkiller can be taken around an hour in advance.

I understand that no method is 100% effective and that the IUD/IUS has a very small risk of failure (less than 1 in 100 chance of pregnancy).

I understand that there is a 1 in 1000 risk of perforation of the womb at the time of insertion of the device.
I understand that there is a 1 in 20 chance of the device falling out. This is highest within the first few weeks after fitting
I understand that the IUD/IUS will not protect against sexually transmitted infections and condoms in addition are recommended for this if for example I have a new partner.
I understand that there is a small risk of infection (1 in 100) in the first few weeks following insertion of a device.
I know that a copper IUD will make my periods slightly heavier, longer and more painful.
I know that an IUS (Mirena) will make my periods much lighter but may cause erratic bleeding and spotting in the first few months of use.
 
Name:  _________________________________         Date: ___________________
Advice After Intrauterine Contraceptive Device Insertion (IUCD)
 
Patient Name:              
Date of Birth:               
NHS Number:               
 
IUCD Details
Name of device fitted:  date inserted
 
Date to be changed:
 
Please keep a note of this date as we are unable to send you a reminder when it needs to be changed.
 
Review Appointment
A routine follow-up may be advised after your first period following insertion of your IUCD but it is not essential.

If you have been advised to return for a review, please make a follow up appointment at 3-6 weeks after IUCD insertion to make sure everything is fine. This can be done at your GP surgery or at the clinic that fitted your IUCD. At this visit, the GP or nurse will check that the device is in place and address any concerns you may have. You should return at any time if you experience problems.
 
If you have made an appointment, please note the date here:
 
Checking your IUCD threads
It is usually possible to feel the threads of the IUCD inside the vagina to check it is in place. Your nurse or doctor will have advised you how to do this at the time of fitting. You should check for the threads of your IUCD after each period or approximately monthly if you are not having regular periods.
 
If you cannot feel the threads, then use an alternative contraceptive method such as condoms until you have had the opportunity to be seen by a doctor or nurse.
 
When to Seek Medical Attention
You should seek medical attention if any of the following occur:
 
• Prolonged lower abdominal pain after the IUCD is inserted, lasting more than 2 weeks; or is getting worse with time; or which goes and then comes back again.
• Raised temperature associated with lower abdominal pain.
• Heavy bleeding after insertion, needing more than 2 sanitary pad changes per hour for more than 2 hours.
• Late menstrual period (with copper-IUD).
• Abnormal vaginal discharge with an offensive odour; with or without pain.
• You can feel the stem of the IUCD.
• You cannot feel your threads.
• The IUCD is causing discomfort to you or your partner during sex.
• You have any other concerns.
 
Will I be in pain after the procedure?
Having an IUCD fitted can be a little uncomfortable but this varies greatly from person to person. Some women may benefit from taking pain relief after the procedure in the form of ibuprofen or paracetamol. It is best to take something that you have used before and which you know you are able to tolerate. You may need to continue with your painkillers for the first 24-48 hours following your procedure, but this also varies from person to person. It might be helpful to make sure you have supplies at home.
 
Will I bleed after the procedure?
It is common to have some bleeding after the procedure. How long you bleed for will depend on the type of IUCD you have had fitted. Bleeding is common in the first 3-6 months after IUS insertion and often settles without treatment.
 
Avoid tampons and use sanitary towels only for the first 7 days following the fitting of your IUCD. After this time, you can use sanitary towels or tampons of your choice. If you use a Moon Cup, please be advised that the manufacturers recommend waiting 6 weeks after IUCD insertion before using the menstrual cup.
 
Will I need to restrict any other activities?
Your doctor or nurse will have advised you when you can rely on your IUCD for contraception. The copper-IUD is effective immediately but the hormonal IUS may take up to 7 days before it works. You should not be aware of the IUCD when you are having sex. If the IUCD causes discomfort to you or your partner during sexual intercourse you should seek medical advice.
 
Avoid the use of vibrating gym plates for the first 3-6 weeks.

Other Guidance
Cervical screening tests or “smears” can be taken whilst your IUCD is in place.
 
An IUCD will not protect against sexually transmitted infections and condoms are recommended if for example you have a new partner.
 
If you are ever referred for an MRI scan you should inform the radiology or x-ray department if you have a copper-IUD in place.
 
Where can I go for more information?
For further information you may visit the following website:  www.patient.info
Consent form
Patient Agreement To Insertion of an Intrauterine System
 
Patient Name:              
Date of Birth:               
NHS Number:               
 
Statement of Health Professional
 
Procedure:
Insertion of intrauterine system
The intended benefits:
Contraception, control of periods, protects the lining of the uterus if using HRT
Possible risks:
Bleeding, pain, infection, contraception failure (<2/1000 over 5 years), uterine perforation (2/1000, around 1,100 if breastfeeding), expulsion (1/20), ectopic pregnancy (overall risk reduced compared to women not using contraception).  Cervical shock (a temporary episode of faintness as the coil is inserted, usually treated by stopping the procedure). Change in bleeding pattern to heavy, irregular, prolonged and/or absent bleeding, hormonal side effects. Lost threads (approx. 18% of insertions)
 
I have also discussed what the procedure is likely to involve, the benefits and risks of any available alternative treatments, the follow-up care required and any particular concerns of those involved.
 
  The following leaflets have been provided:    Information on intrauterine systems
 
Signed:
 
Date:

Name:

Statement of Interpreter (where appropriate)

I have interpreted the information above to the patient to the best of my ability and in a way in which I believe they can understand.
Signed:
 
Date:
16 Jan 2024
Name:
 
Relationship:
 
Statement of Patient
 
I agree: To the procedure as described on this form.
I agree: To following the correct intrauterine system checking procedures afterwards
As far as I am aware: I am not pregnant and understand the risks of sexually transmitted infections.
Signed:
 
Date:

Name:
 
Copy given to patient?        Yes        No
 
Consent Guidance:
www.gov.uk/government/publications/reference-guide-to-consent-for-examination-or-treatment-second-edition

Contraceptive implant (Nexplanon)

What is the Implant?

The contraceptive Implant is a small flexible rod that is inserted just under the skin on the inside of your upper arm. You are usually offered local anaesthetic in the form of a small injection to numb the area before the implant is inserted.

The Implant contains progesterone hormone which is released slowly into your body each day for 3 years.

The Implant prevents your ovaries from releasing any eggs so that you cannot become pregnant.

What is the Implant used for and what are the benefits?

Long term contraception

The Implant is widely used as a long term reversible contraceptive and can be left in place for up to 3 years. It is one of the best forms of contraception, with only one in 100 women getting pregnant (1%)

However, should you wish to get pregnant, fertility returns to Normal when the Implant is removed.

Are there any problems with the implant?

If you are having the implant replaced, occasionally the doctor may not be able to take out your existing implant. This can be because it is embedded deeply under the skin. If this happens, your doctor will refer you to a specialist to have this assessed further.

Are there side effects?

Side effects are more common within the first few months and generally settle after continued use.

Insertion site

These may include bleeding, bruising, infection, scarring.

Local anaesthetic

Please let your doctor know if you have any medication allergies or have had any reactions to any previous anaesthetic. Occasionally, you can experience some skin irritation and itching locally around the injection site.

Hormonal

These may include breast tenderness, headaches, acne, weight changes and symptoms similar to PMS.

Bleeding problems

Some women may experience changes to their bleeding patterns. This usually settles by 3-6 months. We encourage you persevere and speak to your GP if you find this difficult.

Am I suitable for the Implant?

There are some women for whom the implant is not suitable. This will be assessed at the time of counselling. Please inform us if you have any of the following:

  • allergy to progesterone
  • suspected pregnancy
  • unexplained vaginal bleeding
  • irregular bleeding patterns with your periods
  • Breast cancer
  • Liver disease
  • Arterial thromboembolism (clots in the arteries)

How can I prepare for having an Implant fitted?

Timing of fitting

An implant can be put in at any time in your menstrual cycle. If fitted in the first five days of your menstrual cycle, you do not require any further contraception. If fitted at any other time, you will need additional contraception for the first seven days.

Ensuring you are not pregnant

Prior to having your IUS fitted, you will need to ensure you use adequate, reliable contraception or do not have sexual intercourse from your last period. Please inform us if there is a possibility you are  pregnant.

Medications such as anti-epileptics

Tell your nurse/doctor if you are on any medications that affect your liver such as epilepsy medications as these can reduce the effect of the implant contraception

Pain relief

You may feel pain during and after the fitting. We would suggest that you take some painkillers after the fitting if the wound is painful.

What happens during the Implant fitting?

Your appointment will last 20–30 minutes. We will check that you have understood all the information provided and you will be asked to sign a consent form.

You will be asked about allergies. In particular, please inform the healthcare professional if you are allergic to any anaesthetic or rubber.

The skin will be cleaned and then numbed with a local ‘numbing’ agent (anaesthetic).You may still feel the procedure but it should not be painful.

The implant will be fitted and a small dressing and bandage applied.

If you are having your implant replaced or removed

Your doctor will remove your old implant before fitting a new one. They will check they are able to feel the implant under your skin. The skin will be cleaned and then numbed with a local ‘numbing’ agent (anaesthetic). You may still feel the procedure, but it should not be painful.

A small cut will be made close to the tip of the implant and the rod will be removed. Once the rod is removed, you will be provided with dressings. These should stay on for approximately 24-48 hours and the wound kept clean and dry.

If you are having an implant replaced, the doctor may be able to go through the same wound as the last one. However, they will check this is safe to do so. If it is not, then a new site will be used, and the same process will be followed (as above) as if you are having a new implant fitted for the first time.

Care after your implant fitting

We advise you take the bandage off after 24 hours and the dressing underneath off after 48 hours (one day after your bandage removal). It is important you keep the wound clean and dry to avoid infection. You may develop some redness, pain or swelling and we advise you take some pain relief if this occurs. If you develop redness or swelling that is spreading up/down the arm or occurs with a fever or severe pain, then please contact the GP surgery or the urgent care team (If out of GP surgery hours).

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