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?

cardamomginger Thu 31-Oct-13 08:53:41

BTW - good luck! Roaccutane was amazing for me!

emmadash Thu 31-Oct-13 08:57:50

LordEmsworth is right, the implant is more effective than the Pill. Typical use failure rate for the implant is 0.05%, making it the most effective form on this chart. The pill has a typical use failure rate as high as 8% - not really reliable enough if you definitely needed to avoid pg as in this situation.

If you wanted to use Roxanne's approach, a simple way to get hold of a prescription for the Pill without any fuss is to use an reputable online pharmacy. I've ordered from the Superdrug online pharmacy as it was quicker and easier than getting the Pill from GP, just answer their questions in the right way (i.e. ignoring your medical issues, as you won't actually be taking it) and pay about £20. All above board, it gets reviewed by a real doctor and you get sent the pills in the post which you can show it to the dermatologist. Having tried to get my GP to write to consultants in the past/advocate on my behalf, I'd choose this option as far quicker and easier (albeit more expensive) than trying to get my GP to argue with the dermatologist.

fivefourthreetwoone Thu 31-Oct-13 11:12:57

After sleeping on it, I've come to the conclusion that my doctor is a complete loon and I'm going to be looking for a different dermatologist.

I can't believe a doctor would be this clueless about contraception though even if he is a man grin you would still think he would have researched alternative contraception methods, it's not hard.

After looking at that chart that was posted above, I'm actually quite surprised that so many dermatologists suggest the pill over any other contraception seeing as it has a higher failure rate than other methods. That's assuming the person was even taking the pill correctly in the first place...? I guess because the pill is easier, you can just stop taking it after finishing treatment if you want and that's that, it's a shorter acting contraception if you will. But still you really do not want to end up pregnant whilst taking roaccutane.

fivefourthreetwoone Thu 31-Oct-13 11:15:01

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

I think that regular pregnancy tests are a requirement for all females, regardless of what contraception they're using.

APartridgeAmongThePigeons Thu 31-Oct-13 11:16:44

Is it easier for you to get another dermatologist than to get a note from the doctor who put you on the implant explaining the failure rate?

Just thinking that if you have to wait for another appointment it might be worth just calling and getting a note.

fivefourthreetwoone Thu 31-Oct-13 11:24:47

Well I actually can't remember who put my implant in. I had it done at one of those family planning/sexual health clinics rather than my own doctor. It was also put in when I was living at the other end of the country and as it was over a year ago now, I can't remember the name of the doctor. I've checked the little card I got at the time but it just has the name of the clinic on not the doctor who fitted it. Not very helpful, I know.

I suppose I could ask for a note from my GP even if he didn't fit it explaining that I have it and that it is a reliable form of birth control?

I should also add that I'm seeing this dermatologist privately, so if I changed, I would still go private and wouldn't have to sit through NHS queues so actually wouldn't be too much of a hassle to change.

APartridgeAmongThePigeons Thu 31-Oct-13 11:29:20

Oh in that case, I would just swap, you're paying extra for a bit of a dim bulb

fivefourthreetwoone Thu 31-Oct-13 12:45:15

I will deffo be swapping now I've really thought about it. Think I'll be looking for a female this time and will be making sure she's okay to have the implant as contraception before I make any appointments.

AlwaysSleepingBeauty Thu 31-Oct-13 14:45:53

I'm interested to see all the different experiences here, as I was on Roaccutane when I was about 15. I took the pill alongside it, even though I had never even kissed anyone but was never asked to do pregnancy tests. This was about ten years ago.

I'm currently on the pill now, and have always been told by my doctor that the implant often aggravates acne. Could this be why the dermatologist seems keen on the pill?

cardamomginger Thu 31-Oct-13 20:59:51

If you are in London five I can recommend my dermatologist Dr Susan Mayou. She is lovely.

cardamomginger Thu 31-Oct-13 21:00:19

She never asked me to POAS.

fivefourthreetwoone Thu 31-Oct-13 21:56:38

POAS - I actually had to google that blush

Unfortunately though I'm not near London.

have always been told by my doctor that the implant often aggravates acne. Could this be why the dermatologist seems keen on the pill?

Worsening acne is a potential side effect of the implant, but I only started using the implant just over a year ago wheras I've had acne for years. It didn't make my acne worse. I think he's just more concerned about the contraception angle.

cardamomginger Thu 31-Oct-13 22:11:33

Also had to google it quite recently grin. Been looking for an excuse to use it!

Of course the implant is more effective contraception than even the pill - glad to hear you are considering changing your dermatologist.

Is your implant palpable in your arm? Could you demonstrate that it's there? Does your wee card state the date when it was put in?

I am just asking because I am wondering whether your dr feels the need to not trust you with reliable contraception and needs proof?
Although how on earth he'd know whether you are actually taking the pill I don't know... hmm

Roaccutane is v strong medication - which is why it works really well and why it also has significant unwanted effects (to misquote Newton "No action without equal and opposite reaction"). The careful counselling about the drug and regular monitoring is designed to pick up any problems before they are severe. SE are reversible when Roaccutane is stopped.
The one SE every single person I've had dealings with on Roaccutane gets is incredibly dry skin which gets worse as the course carries on. So arm yourself with bucket loads of moisturiser, the heavier and greasier the better. You may be prone to nose bleed (dry nasal lining), sore eyes (due to dryness) and cracked lips. Most people who have acne bad enough to be prescribed Roaccutane are used to having greasy skin and don't know what hit them.

Good luck, I hope you find a dermatologist you are happy with and have a good result from treatment.

BeigeBuffet Thu 31-Oct-13 22:24:54

I'll tell you a bloody effective contraception, depo provera! Nobody is getting pregnant even after they stop taking that!!!

fivefourthreetwoone Thu 31-Oct-13 23:21:33

Is your implant palpable in your arm? Could you demonstrate that it's there? Does your wee card state the date when it was put in?

Yeah, you can feel it's there. I even showed him the card with the date it was put in, date it runs out and the name of the clinic where it was fitted (though like I said before, the name of the doctor who fitted it isn't on there) and even told him he could feel it in my arm if he wanted grin (which he turned down) but he still insisted on the pill.

I've just come to the conclusion he's just very strange indeed.

Although how on earth he'd know whether you are actually taking the pill I don't know...

That's the thing though; I've been doing some reading online and apparently when you have the blood tests they don't actually check to see if you're on hormonal birth control because they don't actually check your hormones in the blood (or something like that). From doing some reading on acne.org it actually isn't unusual for people to say they're taking the pill even though they're not. Some doctors require a prescription as proof but even then some people just get the script but don't bother taking it. And as they don't check hormonal levels in the blood tests, nobody knows they're not taking it. Then there's the issue of even if the pill is been taken, how would the doctor know it's been taken correctly?

Wheras with me, you can actually feel the implant and you can feel it's there.hmm

Like I said above, given the high failure rate the pill (surprised by that chart tbh) along with you can't actually prove whether it's actually been taken or even taken correctly, I'm surprised that it's the first choice method of contraception for a lot of dermatologists when prescribing roaccutane. You really do not want to get pregnant whilst taking it so if you're sexually active presumably you should be using the most effective method you can.

fivefourthreetwoone Thu 31-Oct-13 23:23:00

I'll tell you a bloody effective contraception, depo provera! Nobody is getting pregnant even after they stop taking that!!!

Lol I've heard such horrible things about the depo jab. I don't think I've met a single person who has had a good experience with it but obviously it must work for some people otherwise it wouldn't still be available.

SeaSickSal Fri 01-Nov-13 00:37:41

Have you been checked for polycystic ovary syndrome? That causes acne. Do you have irregular periods or excess weight/hair

Nope, hormone levels for people on the pill are not checked - too easily confused with own natural hormones, there is no point.

I am involved in Roaccutane prescribing and I am v familiar with all the issues including reliable contraception, but it gets me feminist goat that after careful discussion and counselling the contraception side is not left to the woman.

MHRA approving of implant

Or was he wanting you to have the pill AND the implant ie the fabled two methods?? Rather than, say, implant and condoms.

I may now be overthinking this...

NeedlesCuties Fri 01-Nov-13 20:00:42

Interesting thread!

I've had the implant in since Nov 2012, and also take the combined pill due to heavy periods caused by the implant. Your derm doctor would love me grin

fivefourthreetwoone Sat 02-Nov-13 23:06:46

Nah, I've never had irregular periods or problems with weight gain so I don't think it's polycystic ovary syndrome. I think I've just been really unlucky in having really bad skin.

CamelBalls Sat 02-Nov-13 23:32:28

I was offered this in August - and was told I must be on two forms on contraption, because o the harm it would do to the baby, I was also told I would sign a form saying if I fell pregnant whilst on the medication I would have to have a abortion shock

Don't want to go on two forms on pill as makes me put on weight and have lost 3 stone this year so think unfort I'm going to leave it....

CamelBalls, you wouldn't need to take 2 types of the pill: it could be pill + condoms, or coil + condoms if you want to avoid additional hormones altogether. Any form of hormone treatment (contraception, HRT or fertility drugs) can give some people a horrific appetite, hence the weight gain. It's not the pill that kind of 'passively' puts weight on you, so some people with previous weight gain problems manage fine on hormonal contraception as long as they are very aware of what they eat (and don't suffer from Hand To Mouth Disease like I do....blush).

If you were to conceive on Roaccutane the resultant fetus would be severely affected, if not terminated the pregnancy is likely to end in miscarriage and if the pregnancy was continued would likely end early with a severely affected baby whose malformations are likely to not be compatible with life.

It IS a nasty drug that works VERY well for severe acne.
Not a step to be taken lightly.

CamelBalls Sun 03-Nov-13 15:22:11

He told me I would need to take two lots of contraption - ie pill and implant, pill and coil etc
I was eating the same amount and doing the same amount of excerise in the same job and I put on about 4 stone :O it took me ages to shift it hence why I really don't want to go on this medication, I would take it otherwise.

I understand about the pregnancy/fetus - but it kind of scares me signing a form saying I would have a abortion if this happens, even though I'm not planning for children for a long time yet.

Oh, I know, it is a really scary drug.
You do know that nobody could legally hold you to the 'contract' you signed though, don't you? It is more a form to make sure you have fully understood what the consequences of a pregnancy on Roaccutane are.

My understanding was that barrier contraception ie condoms would be 'permissable' as one of the forms of contraception. Ah, well.

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