To think that the implant is a reliable form of contraception?

(57 Posts)
fivefourthreetwoone Wed 30-Oct-13 22:41:19

I've had acne for years now. I've tried every over the counter remedy, every antibiotic prescribed by my GP and dermatologist but nothing has worked. We're now down to the last resort of trying roaccutane. I've read up on all the risks and am aware of how important it is not to get pregnant on it because of the birth defects. I have decided however that this is the last resort and am willing to try it to get rid of my acne.

I have the implant and thought that would be okay on the contraception front but at my appointment with my dermatologist today, he insisted that I must be taking the pill before he can prescribe it. I explained that I have the implant but he was insistent that the implant wasn't good enough and that it had to be the pill.

The thing is though, I can't take the pill for medical reasons (that's the only reason I have the implant for!) otherwise I would be on the pill anyways.

I was actually quite confused about this and have done some reading. Apparently the implant is over 99% effective, which is the same (or slightly better?) than the pill.

Is it standard that the only accepted contraception is the pill when taking roaccutane or is my derm just odd?

RoxanneReidsChafingFishnets Wed 30-Oct-13 22:46:18

Is that drug even safe to take? Doesn't it babe dangerous side effects? I'm sure I saw a programme about it

fivefourthreetwoone Wed 30-Oct-13 22:48:06

It can have bad side effects, yes, such as depression, birth defects, etc. That's why you're monitored carefully throughout treatment and have regular tests.

Really though I'm desperate to try anything now. I just want my acne to go away.

ShowMeYourTARDIS Wed 30-Oct-13 22:49:25

I've always heard the implant was more effective than the pill, partly because you can't forget to take it. With the pill, there's always the chance you'll forget, lose the pack, throw it up, etc.

RoxanneReidsChafingFishnets Wed 30-Oct-13 22:51:12

Get a prescription for pill, show him it, get roaccutane, dont take pill

AnyChippednailvarnishfucker Wed 30-Oct-13 22:53:23

I've never heard this before OP - contraception yes, it having to be the pill, no.
You have my sympathies acne is very depressing, on the plus side I know people who have used roaccutane and had fantastic results.
Good luck.

APartridgeAmongThePigeons Wed 30-Oct-13 22:54:05

Effectiveness is an important and common concern when choosing a birth control method. The birth control implant is very effective. Less than 1 out of 100 women a year will become pregnant using the implant. It lasts up to three years.

So in other words exactly the same as the pill, except you can't fuck it up and forget it.Get a different doctor to prescribe, he's being ridiculous

meditrina Wed 30-Oct-13 22:55:24

NHS page says you need to be on one, ideally two forms of reliable contraception but does not specify which type.

I'd have thought implant was better than the pill (no chance of user error).

I hope you get this sorted out.

Btw: remember that you mustn't give blood whilst taking it and for one month afterwards whilst it clears your ody.

APartridgeAmongThePigeons Wed 30-Oct-13 22:56:00

www.nhs.uk/medicine-guides/pages/MedicineOverview.aspx?condition=Acne&medicine=Roaccutane&preparationRoaccutane%2020mg%20capsules

Roaccutane may harm a baby if it is taken during pregnancy. It may also increase the chances of having a miscarriage. Women must not become pregnant while they are taking Roaccutane. For this reason women who could become pregnant are only prescribed Roaccutane if they are very careful about using contraception to prevent pregnancy. Women who are being treated with Roaccutane and who do not have a menstrual period or who are not currently sexually active must also use contraception.

If you are a woman and you are taking Roaccutane, you must not become pregnant during treatment and for at least one month after stopping treatment with Roaccutane. You must use one form, or preferably two forms, of effective contraception one month before you begin treatment with Roaccutane.

You must continue to use this contraception while you are taking Roaccutane and for at least a month after you have stopped taking Roaccutane. During this time, if you become pregnant, or think you have become pregnant, you must immediately contact your prescriber. For more information about using contraception and what types of contraception should be used while taking Roaccutane talk to your prescriber or read the Patient Information Leaflet that comes with your medicine.

Treatment with Roaccutane can only be started in a woman once the prescriber is certain that the woman is not pregnant. Women will need to have a pregnancy test before, during and five weeks after stopping treatment with Roaccutane. For more information about pregnancy tests during treatment with Roaccutane, talk to your prescriber.

Edendance Wed 30-Oct-13 22:57:35

Good for you to get roaccutane! I was on it for 6 months when I was 14-15 and it's fantastic stuff. I had the usual minor side effects, pink/dry skin and dry inside of nose but I only had to wash my hair once a week- result!

Re contraceptive, the doctor sounds ignorant of the most up to date options, I would try and get yourself a 2nd opinion to be honest.

APartridgeAmongThePigeons Wed 30-Oct-13 22:58:15

It says nothing about which form of BC you need to use, just a reliable one.

I think it's shit they can dictate that tbh, I understand you don't want to get pg on it, but maybe you don't want to take hormonal contraceptive you shouldn't have to.

What if you're a nun? hmm confused

APartridgeAmongThePigeons Wed 30-Oct-13 22:58:49

Maybe get a note from the doctor who installed the implant?

CoffeeTea103 Wed 30-Oct-13 23:01:27

I was on roaccutane for 8 months and it's definitely the best treatment for severe acne. I was also advised on taking the pill, but as I had already been on it I didn't question alternative measures. They will test you for pregnancy before prescribing it, and also at every checkup.

meditrina Wed 30-Oct-13 23:03:21

Patint information leaflet here. It doesn't specify type of contraception, but does recommend doubling up with a barrier method as well.

It doesn't mention nuns, but does say that even women who are not sexually active at time of prescribing should be referred or contraceptive advice (unless compelling reasons otherwise - which might encompass Holy Vows I suppose).

fivefourthreetwoone Wed 30-Oct-13 23:07:39

I'd have thought implant was better than the pill (no chance of user error).

That's what I was thinking. I mean, you can forget to take the pill or take it at the wrong time and that would impact how effective it was...you can't do that with the implant because it's always there if you see what I mean.

Things like vomiting and diarrhea can make the pill less effective too which I don't think is the case for the implant.

Get a prescription for pill, show him it, get roaccutane, dont take pill

I would actually do that but my GP won't actually prescribe me the pill. Like I said, I can't take it on medical grounds, hence no doctor would actually give me a prescription. It's not just me being fussy about not wanting to take it. The pill actually would be my first choice of contraception if I could take it.

justabigdisco Wed 30-Oct-13 23:13:25

The implant is the most effective contraceptive there is. Can you get your GP to write to the dermatologist and perhaps offer to teach them a thing or two about contraception?

fivefourthreetwoone Wed 30-Oct-13 23:14:31

Sort of OT here, but how recent is the contraception requirement when taking roaccutane? I keep reading that all women of child bearing age must take one, preferably two, forms of birth control but I have a friend who took roaccutane about ten years ago and she wasn't required to use any form of contraception at all. She just had to swear to remain abstinent during the course of the treatment and sign a form saying she wouldn't get pregnant and that was it. confused Like I said, that was years ago though.

I actually think her derm was either very trustworthy or incredibly stupid letting her do that, I can't decide which.grin

If I take roaccutane, I'd be doubling up with condoms anyways, so the implant and condoms should count as two methods.

I'll talk to my dermatologist again. If he still insists on the pill, I guess I'll have to find another doctor.

APartridgeAmongThePigeons Wed 30-Oct-13 23:15:27

What if you are a nun and the only male around the grounds is a male game keepers whos had the snip?

Is that two forms of contraception?

Also do they make young girls take the pill 11 or 12?

fivefourthreetwoone Wed 30-Oct-13 23:22:46

*What if you are a nun and the only male around the grounds is a male game keepers whos had the snip?

Is that two forms of contraception?

Also do they make young girls take the pill 11 or 12?*

Apparently in America you're allowed to select abstinence as a form of birth control when taking it. However not every doctor there accepts that, but it is considered to be a valid form over there. I'm not sure if it's the same over here? Like I said above, a friend of mine was allowed to use abstinence as her method of birth control and that was it, but like I said, that was years ago.

Tbh I think the birth control thing is just to cover the doctors back more than anything else. It's so people can't sue them if you do get pregnant. So can't really answer your nun question lol. Not sure what they'd do.

I don't think many doctors would actually prescribe roaccutane to 11 or 12-year-olds anyways because it is a very strong drug. I'd imagine though that yes, the requirement would apply to them too...

PepsiBubbles Wed 30-Oct-13 23:38:01

I didn't have to use contraception when I was on roaccutane neither. My dermatologist told me that it is 'recommended' you go on the pill but didn't say I had to so in the end I didn't. I just had to sign a form saying I would remain abstinent throughout. This was 6 years ago.

LordEmsworth Thu 31-Oct-13 08:41:52

My GP told me the implant is more effective than the pill. Your dermatologist is presumably a man who can't be bothered to look into contraceptive techniques?

As an aside - have you read Jillian Michaels' Master Your Metabolism? In the first chapter she talks about her experiences with weight loss and the impact on her hormones, taking Accutane (is that the same thing?) and how she "overcame" it. I am not saying don't go on the Roaccutane - just that you might find it interesting to read...

happygirl87 Thu 31-Oct-13 08:44:39

Friend of mine took it and had to do regular pregnancy tests at the dr- could that be an option for you? See if that will appease the dermatologist. Otherwise you could a) ask him for a prescription for the pill (and not take it), b) ask your GP for a letter to dermatologist saying you cant take the pill but have implant which so more reliable, or c) get a new dermatologist, cos he sounds like a twat! (But I know it's not always that easy) good luck!

Edendance Thu 31-Oct-13 08:45:09

I didn't go on any form of contraceptive when I was on it at 15, I hadn't even kissed anyone by that point and was mortified when my mum got me to say for myself that I wasn't going to get pregnant while on it, in the appointment!

killpeppa Thu 31-Oct-13 08:45:48

I have the implant after getting pregnant on the pill TWICE!

its fab, no worries no remembering and 99% effective

cardamomginger Thu 31-Oct-13 08:53:25

I was on roaccutane, was monitored with monthly appoointments and blood tests to check liver function. I was told I just had to be on contraception when using it and for 1 month afterwards. She didn't say which sort, but thinking about it I guess the pill is the 'easiest' in terms of an add-on as it is non-invasive and has a short wash-out period if you want to stop taking it.

I think the doctor is being ridiculous in not accepting implant plus condoms. Rather than have the faff of finding another dermatologist, can't you just get the pills prescribed and not take them? OTOH if she/he is being so silly about this, maybe she/he is not the best person to see - what else might they be silly about??

Sorry just seen you can't take the pill. Change then - if the dermatologist is so inflexible and can't actually be bothered to look at the reality of the medical situation, i.e..implant works and you can't have the pill, then they can't be a very good doctor IMHO.

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