Patient Information

What Happens at Your Appointment?

We usually start by talking about your concerns and symptoms and getting some details around your general health. It can be useful to have a list of any medications you are on. If required, an examination may be carried out which may include an internal examination and a transvaginal scan. You may need a biopsy or a blood test and this will be discussed with you prior to anything being done.

You will get a copy of your notes and a digital copy of any scan images from the appointment. You may also get a letter to hand in to your GP, as well as information leaflets that will help with your understanding of your condition as well as treatment options. I aim to have these e-mailed to you within 7 working days.

Results of blood tests and biopsies can take anywhere from 2 days to 3 weeks depending on the test being done. You will be e-mailed a copy of the results once they are available.

Please bring a friend or your partner with you for support if you want but it does help to not have more than 1 other person in the consultation with you. You may feel faint after some procedures so is it advisable to either not drive yourself or allow enough time to recover before driving. There are some refreshments provided in the waiting area while you wait.

There is some information in the health advice section that you may find useful to look at prior to your appointment if you are having a procedure carried out.

A follow up appointment is sometimes needed to assess progress with treatment, discuss possible side effects and look at alternatives if required or a repeat ultrasound scan. There may also need to be a planned annual review for some patients on HRT where a blood test may be recommended to check hormone levels.

Information About The Contraceptive Implant

The contraceptive implant Nexplanon is a long acting hormonal contraceptive which is inserted under the skin of your arm. It contains Etonogestrel, a progestogen. The implant lasts for 3 years and is 99% effective at preventing pregnancy.

It works by preventing the release of an egg from the ovaries ,thickening the cervical mucus to make it difficult for sperm to enter the womb and thins the lining of the womb.

Implant Insertion

Prior to the implant insertion, you will have a short consultation to determine if it’s suitable for you. Some people have a pregnancy test carried out prior to the insertion if there is a risk they might be pregnant on the day of the appointment.

The implant is inserted just under the skin of your arm using local anaesthetic. Paper stitches are applied which are removed after 4-5 days, and a pressure bandage to reduce swelling and bruising is used for 24 hours.

You should be be able to feel the implant after insertion. You will be given some information on wound care after your appointment.

If the implant is inserted on day 1-5 of your cycle (day 1 is the first day of your period) then it is effective immediately. If it is inserted at any other time of your cycle, you need to use back up contraception ( condoms) or continue with your current method of contraception for 7 days until your implant is effective. The implant is effective for 3 years. The risk of getting pregnant in the 4th year is very low, but you may wish to get it replaced after 3 years or use additional methods of contraception.

Implant Removal

For implant removals in this clinic, the implant needs to be easily felt under the skin. If you are unable to feel your implant it may have been inserted too deep and you will be referred to a deep implant removal service to be seen by a specialist who is trained in complex implant removals after a scan.

Implants are removed under local anaesthetic through a small incision made in the skin. Paper stitches are applied and can be removed after 4-5 days, and a pressure bandage to reduce swelling and bruising is used for 24 hours.

A new implant can be inserted immediately after the old implant is removed using the same incision as long as it is in the correct location.

Once an implant has been removed, the hormone level drops in 7 days and pregnancies have been reported within 14 days of an implant removal. If you need alternative contraception, this can be discussed at your appointment.

You will be given some information on wound care after your appointment.

Risks and Complications

After an insertion or removal, some bruising, pain, swelling and itching may occur. There will be a small scar. Expulsion or migration of the implant after insertion is possible. There is a risk of infection at the wound site- if you experience redness, swelling or discharge from the site, please see your GP as you may have an infection and may need antibiotics.

Advantages of Using The Implant

  • Very reliable – 99% effective at preventing pregnancy.
  • It can help improve painful periods.
  • It can help with endometriosis pain
  • Some women experience lighter periods
  • No long term effects on fertility

Possible Side Effects of The Implant

Common- ( may affect more than 1 in 10 people)- acne , headache, nausea, breast tenderness, irregular bleeding. 1 in 5 women had no bleeding, 1 in 5 had frequent and/or prolonged bleeding. The bleeding pattern can be unpredictable and change at any time. If you have troublesome bleeding after the implant insertion, around 50% of women find that it improves with time.

Some women have reported mood changes and weight gain with the implant but there is no evidence that these are caused by the implant. There are other side effects that are listed in your implant information sheet which are not as common.

Do Not Use Nexplanon

  • If you are allergic to Etonogestrel
  • If you have a thrombosis ( blood clot)
  • If you have jaundice or severe liver disease.
  • If you are pregnant or suspect you may be pregnant.
  • If you have breast cancer
  • If you have had a stroke or heart disease.
  • If you have any unexplained bleeding

More information on the implant can be found on
NHS Inform – nhsinform.scot
Sexual Health Scotland – sexualhealthscotland.co.uk
www.nhs.uk