Alternatives to implant (ideally long-term options)?

bleeding
side-effects
contraception

#1

I’m coming to the end of my second implant and considering whether I want another one or to switch. However, every method seems to have drawbacks and positives -there’s a horror story and a matching ‘I love it’ story for every method! I’m mid-30s, no kids and currently no plans to have any, long-term partner.

For me the implant is ok at first but for the last year of it I get very frequent bleeding and bloating alongside that - it’s really annoying. I think it may also affect my mood though it’s hard to tell (for the first few months of my first one I was on continuous oral steroids too) - but I do feel like I still get some bad mood swings now that I think may be the implant. I know it isn’t the same as what’s in the implant, but when I tried norethisterone tablets to delay my period on holiday years ago (way before the implant or steroid use) I was a mess mood wise, so I’m a bit wary about what the various hormonal options might do to my mood.

I’d ideally like something I can just forget about (hence the choice of an implant), and wondering if the copper coil would be better than the hormonal options as far as mood, bleeding and bloating are concerned? I know it can cause heavier bleeding but is that once a month at least? I am really sick of having a period so often even if it at least isn’t heavy currently, but I don’t want to turn my periods into a horror show.

Not sure about the pill options because I already take so many medications - I feel like it’s just one more thing I have to remember. I’m good at taking meds and not forgetting but if I do forget the pill the consequences might be much greater than needing a bit more ventolin! I also don’t want to worry about the timing being off or forgetting if I’m in hospital.

Trying to decide now as implant will run out in December, I’m getting fed up with the bleeding already and I’m worried about more lockdown in autumn/winter and not being able to access services - is it even possible to get implant/coil inserted or removed at the moment? (Also paranoid about implant not working towards the end).

Looking for user experiences but would also appreciate some expert input from @Dr_Paula


#2

Hello @Hero2020

Many thanks for sharing your contraceptive situation - I expect there are many others grappling with the same issue.

First - if the implant works for you and you get bleeding in the last year - then you could get it changed earlier - aim to use each implant for 2 years instead of 3.

I hear what you say about hormones and mood swings - there is a lot of conflicting evidence in this area and no conclusive evidence to say that the implant does cause mood swings, but a lot of individual stories that suggest that it may for some people.

The copper coil is effective and safe. It is highly likely that your periods will be longer and heavier. This does tend to get better during the first few months, but in my experience, most people continue to have periods that are longer and heavier than the period they would normally get without the coil in. As the copper coil does not change the length of your cycle, the pattern of your periods should be the same as without the coil in. That might be regular or irregular, depending on what is normal for. you.

The hormone coil is an option in that most of the progestagen remains local. There is some circulating hormone and some people do experience hormonal side effects but the amount of hormone circulating around your blood stream is much less than with the other hormonal methods. It is very effective contraception. It can cause a lot of irregular bleeding in the first few months after it is fitted but this usually settles down to no periods or infrequent periods.

I don’t think you need to worry about the implant not working towards the end of the 3 years. It is likely, (but not guaranteed) that it will work much longer than 3 years, so it should be effective right up to the end of the 3 years.

At the moment most clinics are removing implants and fitting coils, but you usually have to contact them by telephone first and they will take your history and then book you into an appointment.

Hope helpful

Paula


#3

Thanks - yes that’s really helpful and reassuring re the implant usually lasting longer. I did get the implant replaced early last time partly due to bleeding, but a lot of grumbling from the nurse about how unnecessary that was. Good to know the hormone is more localised with Mirena etc - leaning towards that currently!