Although we are always happy to see women for a discussion of contraceptive options or provide another opinion, your local family doctor is perfectly placed to start discussing the various options. In a broad sense, the options can be grouped as:
Long-acting reversible contraceptives, or LARCs for short, provide the best contraceptive rates, allow an almost immediate return to fertility once removed, and have been shown in long term studies to be the most well tolerated. There are two main groups of LARCs described below – the hormone releasing rod which is placed under the skin or an intrauterine device which can be either hormonal or non-hormonal. Dr Budden has extensive experience at inserting and removing LARCs and in those rare circumstances where the procedure is too difficult or uncomfortable to perform in the specialist rooms, he can organise for it to be performed under sedation in the hospital.
Commonly known by its brand name “Implanon”, this contraceptive device slowly releases the hormone progesterone over three years. To insert the device, your doctor will clean an area under your left or right arm and then inject a small amount of local anaesthetic under the skin. Once this has taken effect, the rod is inserted and both you and the doctor should feel it to make sure you know where it is. When it is time to be removed, the rod is located by feel and then local anaesthetic is placed under the skin near one end of the rod. A small cut in the skin is made over this end and the rod is removed.
There are two main types of intrauterine device (IUD) commonly used in Australia:
Both devices are placed and removed in the same manner. Prior to any IUD being inserted, Dr Budden will run through the procedure and check if you have any questions. He may also run tests for sexually transmitted infections or pregnancy as an IUD should never be inserted in these circumstances. It is recommended that you take an anti-inflammatory such as Ibuprofen an hour prior to the procedure and Dr Budden will also use local anaesthetic at the time of the procedure.
To insert the device, Dr Budden will perform an internal examination with a speculum to assess your cervix. If needed, you can have a Cervical Screening Test taken at the same time. Cleaning solution will then be applied to the cervix to reduce the chance of infection, before a small device is passed through the cervix into the uterus to ensure the IUD will be placed correctly. Finally, the IUD is inserted and the speculum is removed.
When you want the IUD removed, an internal examination with a speculum is required to identify the small strings attached to the IUD. These are grasped and the device is gently removed. If desired, another IUD can be placed on the same day.