Hormones

implant
side-effects
bleeding

#1

Hey Dr Paula. I was on the implant for 8 years (3 implants). It was great, stopped my periods and no complications - no side effects, nothing. When I flew to Thailand in November, my periods started again. They weren’t consistentcy and I was bleeding heavily. I had the implant out and since I’ve been having regular periods again, but these are 20 days in between - not a month? I’ve been tracking with my Fitbit. I need to go back onto contraception but do not want any complications or side effects like weight gain, bad skin, mood swings etc.

I’d preferably like a form of contraception that stops my periods again, but I don’t know if this is wise to do so. Some people have said it can effect pregnancy and although I don’t want kids now, I will want them in the future. I’ve turned a bit skeptical in general about contraception in general for these reasons hence why I am not currently on anything. Sex has been risky though because I don’t like using condoms… so I kind of need to do something about it.

I don’t want the coil (heard nightmares about them.
I don’t want to go on the pill (I’m forgetful and also my GP refused me years back because I’m a smoker).
I don’t see the point in trying the implant again because it didn’t agree with me towards the end.
I don’t want to go on the injection as I’ve heard about weight gain and my GP advised against because it’s a big dollop of hormone instead of gradually releasing it.
Not entirely sure about a patch being on my body tbh.

These are all of the reasons I’m choosing not to be on contraception at the moment - I just don’t think anything will suit me.

A few questions though:

  1. Is it wise to be on contraception (that stops periods) if I want kids in the future?
  2. Do you think it may have been a faulty implant? Or my body finally rejecting it after 8 years of use?
  3. What do you recommend I’d do?

Thanks so much Dr Paula!

x


Irregular bleeding with the implant. Same implant different side effects?
#2

Hi Lindsay,
Many thanks for posting - you raise important questions.

In response to your question about contraception that stops your period. All the evidence is that this will have no effect on your long term fertility at all. The only method where your periods can be slow to return after stopping is the injection. Even with this your fertility will return to what it was before but it may take a bit longer than some of the other methods.

In response to your question about bleeding on the implant - bleeding patterns vary. Even if you have been fine with your first implant you may have irregular bleeding with your second and vice versa. The reason for this is that the hormone from the implant is not the only hormone in your body. You will still have some natural hormone and the levels of this may change. Also the response of the lining of your womb to the hormone in the implant may vary over time. It is difficult to predict what your bleeding pattern will be on another implant but it may be worth a try - it has suited you in the past…

It might also be worth reviewing the information on contraceptives on the SH:24 pages - maybe go through each method in detail. Smoking is usually only a contraindication to the combined pill if you are over 35. It could be worth trying an implant again. It would be worth unpicking what sort of nightmares that you have heard about the coil - we are writing new pages on the process of fitting - that tries to provide as much info as possible. You might try the progestagen only pill - very low dose - basically no health risks but you will need to remember to take it … Some people put on weight on the injectables and some do not. The patch is a bit like a nicotine patch, in case that helps to think about what it might feel like, but you also cannot take this if you are a smoker over the age of 35.

In my experience it is usually possible to find a method of contraception that suits everyone as long as they have access to enough information and have a way to try out each one and test how they feel. Many also have positive effects on your health e.g. reducing acne or making periods lighter and more regular and it is worth also considering this.

Many thanks for starting this discussion - I’m happy to answer other questions.

Paula


#3

#4

Hi Paula,

Thanks so much for getting back to me!

Thanks for thoroughly explaining my bleeding patterns… I saw two GPs about this and neither were of any use! I’ve understood a lot more just from your paragraph, so thank you! I may give the implant another go since it was so well suited for me for so long now! But also, sorry another pointer. When I was on the implant my boobs were consistently the same size - always. Now, when I’m due on they probably grow to like, a DD. As soon as my cycle finishes they go back down to my standard B/C size! Is this normal? Or does this mean my hormones are all over the shop?

Work has been a little hectic but I’m going to dedicate some time tomorrow to reading through the SH:24 pages.

Re. the coil… a few of my close friends tried it for a short period of time. All said it was really painful when they had it fitted and they also could feel it during sex… said it felt like a bit of a throbbing pain! One of the girls is a regular spinner (spin cycling class) she couldn’t cycle for a week - too painful to sit on the seat! My pain threshold is ok, but this just put me off. Also, I’ve heard before that it’s for women after children? My mums used the coil for some time now.

Thanks so much for your help Paula! Will get back to you after I have a read through the site!!

Lindsay x


#5

Hi Lindsay

Thanks for helping us start the discussions on this forum. These seem like really important questions - are you OK for me to make them visible on the discussion forum so that other people who might face the same issues can see the questions and answers - no worries if not…

You are asking about cyclical breast tenderness and enlargement that has happened since you stopped the implant. It sounds like when you were on the implant you were not ovulating - that is not going through a menstrual cycle with its associated hormonal changes as the egg develops, ovulation occurs and then if there is no fertilisation you have your period. Thats fine, many contraceptive methods work by stopping ovulation. The implant stops ovulation in some people and not others. It sounds like now you have stopped the implant you are going through a normal menstrual cycle again. Pre-menstrual breast tenderness and enlargement is very often part of this. It is part of your body’s preparation for a potential pregnancy each month. One of the benefits of contraceptive methods that stop ovulation is that they may reduce pre-menstrual symptoms.

In relation to the IUD fitting process this is the text that we are currently working on - we are not sure whether it is too much information so would be good to have your views.

Having an IUD fitted may be uncomfortable or painful. It tends to be more painful if you have not had a pregnancy and natural birth (vaginal delivery). The IUD is inserted through the vagina and then through the cervix or neck of the womb. It involves inserting a speculum (an instrument that holds open the walls of the vagina so that the neck of the womb can be seen). This is the same instrument that is used when a smear test is taken. Forceps are then used to hold the cervix steady. These pinch the neck of the womb and may cause pain which then settles after a few minutes. The length of the womb is then measured with a sterile probe to check how far the IUD should be inserted. This stretches the narrow opening of the neck of the womb and may cause period type pain. After this the IUD is inserted. This comes packed in a narrow tube with the IUD arms folded down. Again this may cause period type pain as it passes through the narrow opening of the neck of the womb. The IUD is then released from its tube inside the womb and the tube is removed. Then the forceps and speculum are removed. If straightforward the whole process should take about 5 mins. People normally have some cramping pain afterwards which takes a few minutes to settle. Occasionally people feel nauseous or faint afterwards. They may need to lie down for 5-10 mins after the procedure but are usually fine after this. Some women - particularly those who have had a vaginal delivery in the past find the procedure pain free.

Hope helpful. Do get back to me about whether you are OK to make the conversation visible.

Paula


#6

Hi Paula,

Yes of course - I think I was meant to post directly into the forum instead of direct messaging - my error! Post away!

Thanks for the run through re. breast enlargement! Crikey there’s such a difference in them!

Feedback in**(xxx)** below…

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Having an IUD fitted may be uncomfortable or painful. It tends to be more painful if you have not had a pregnancy and natural birth (vaginal delivery). The IUD is inserted through the vagina and then through the cervix or neck (the word neck just made me cringe a little) of the womb. It involves inserting a speculum (an instrument that holds open the walls of the vagina so that the neck (Double cringe!) of the womb can be seen). This is the same instrument that is used when a smear test is taken. (This is good - I had a smear and didn’t see what all the fuss was about, I was fine!) Forceps are then used to hold the cervix steady. These pinch the neck (CRINGE x3)* of the womb and may cause pain which then settles after a few minutes. The length of the womb is then measured with a sterile probe to check how far the IUD should be inserted. This stretches the narrow opening of the neck (4) of the womb and may cause period type pain. After this the IUD is inserted. This comes packed in a narrow tube with the IUD arms folded down. Again this may cause period type pain as it passes through the narrow opening of the neck of the womb. The IUD is then released from its tube inside the womb and the tube is removed. Then the forceps and speculum are removed. If straightforward the whole process should take about 5 mins. People normally have some cramping pain afterwards which takes a few minutes to settle. Occasionally people feel nauseous or faint afterwards. They may need to lie down for 5-10 mins after the procedure but are usually fine after this. Some women - particularly those who have had a vaginal delivery in the past find the procedure pain free.

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I don’t think it’s too much information, but from reading it, in all honestly I’m not convinced. It’s actually confirmed that I would not like to have the coil. I don’t know if that’s a good or a bad thing? We need to know the truth right, and it’s good you’ve gone into detail… as I’ve mentioned a few times I do really cringe with the word ‘neck’ I don’t know why. Perhaps it’s just about reshaping the copy? I remember working with a clinician on my previous Masters course, she was a Doctor. She used to say words like ‘cut’ as if it didn’t mean to cut and I used to nearly VOM!! But I also understand in clinician world, it’s just normal terminology. What about diagrams? Or maybe even like a flow chart vibe, diagram showing the different steps - at least you’re reassured as to how far through the process you are when reading. It could be like 4. IUD inserted. (Diagram) You may feel a period type cramp. I don’t know… but I think I could cope with diagrams and captions better to be honest. It’s quite heavy text and I’m a bit on edge as to what I’ll read next in total honesty.

Hope this is ok? Open to feedback on anything else!

Thanks so much for your time again Paula :slight_smile:

x