To think the implant should be recommended more to young girls?

(46 Posts)
TinkyWinkyDipsyLalaPo Mon 21-Apr-14 23:26:22

It might just be my area of the country, but the pill seems to be the standard contraception recommended and given, or was to me as a teenager anyway.

The pill is (I think?) 98% effective if taken correctly, so not accounting for one off forgetfulness, stomach bugs so on, after a year there's a 2% chance of pregnancy, so after 5 years that's a 10% chance.

I got pregnant at 19 after taking it on time, and I seem to know more women who have had unplanned babies or abortions from being on the pill than women who have not having fallen pregnant on it.

I'm now on the implant, which seems close to 100% effective from reading up on it, and other than it costing more I don't understand why doctors don't give more information on it and recommend it over the pill, especially for teenagers who might not even know about it and just go for the pill as standard because it's more commonly known about.

Famzilla Mon 21-Apr-14 23:28:33

I got pregnant with the implant. I was a teenage girl. It also made me incredibly spotty.

TheDoctrineOfSnatch Mon 21-Apr-14 23:31:09

"The pill is (I think?) 98% effective if taken correctly, so not accounting for one off forgetfulness, stomach bugs so on, after a year there's a 2% chance of pregnancy, so after 5 years that's a 10% chanc"

It doesn't mean that, it means for every 100 women taking the pill correctly, 2 will get pregnant in any given year.

TheDoctrineOfSnatch Mon 21-Apr-14 23:34:04

No contraception is 100% effective.

I imagine more teenagers get the pill because they are unlikely to be in their "for life" or "for years on end" relationship and may prefer the choice to stop and start the pill if they split up with boyfriends etc.

ItsAllGoingToBeFine Mon 21-Apr-14 23:35:03

I am think the pill is also a fair bit cheaper than the implant?

Goofymum Mon 21-Apr-14 23:35:52

All women should be given advice about a range of contraception including the pill, implant, coil. Some pills have a very narrow window for them to be taken to be effective and this can be difficult for some women especially teenagers. Practice nurses and gps are now recommended to offer all forms of contraception but often they don't. Sometimes they do but the women prefer the pill because it's what they know.

I had to have an implant removed because I had not stopped bleeding for over 6 months and I swear I was a hormonal mess on it.

Much easier to stop taking a pill that is causing bad side effects and change to another, than have to have something cut out.

Also, I would worry that younger teenagers could be talked in by HCP to have it left in if they wanted it out for any reason.

fuckthefuckofff Mon 21-Apr-14 23:36:39

The pills fairly easy to stop for adverse reactions compared to the implant also.

Goofymum Mon 21-Apr-14 23:38:47

The coil and implants are more cost effective than the pill at 1 year taking into account unwanted pregancies rates with each method. But yes, implant is expensive for the actual device vs pill.

Fefifo Mon 21-Apr-14 23:41:42

I don't think any contraception should be recommended or given to teenagers other than condoms.

Ponkypink Mon 21-Apr-14 23:48:54

I wish people wouldn't forget that some kinds of contraception (or for the unlucky amongst us, most forms of contraception) can have horrendous side effects. It would be extremely stupid to start a difficult to reverse form of hormonal contraception without first trying a more reversable form to see if side effects are suffered. There is no point taking something to prevent pregnancy if the side effect is e.g. suicidal depression such that you aren't even able to consider sex in the first place- sure it's very effective, but no one sensible could consider it reasonable.

Also er statistics don't work quite how you seem to think. You can't just add up a probability over years like that, it's the same each year but you don't know if it's independent or e.g specific to some women who find the pill less effective.

nomcphee Mon 21-Apr-14 23:51:53

I think the implant is a great contraception, the modern version is extremely reliable (the earlier ones had a higher failure rate). If I had a dd I'd definitely encourage her to use it (and definitely better than condoms alone, since the typical use failure rate for that is pretty high - though I'd encourage use of doubling up with condoms). I don't think the Pill is a great contraceptive for all the reasons you mention. But I'm not sure if it's right for doctors to be recommending it though, as it's a bit more complicated to fit and to come off it.

ImAThrillseekerBunny Tue 22-Apr-14 00:00:03

Failure rate of condoms is very high though fefifo, especially for teens. They're just not good enough on their own in a situation where avoiding pg is a very high priority.

I think that the implant should be pushed heavily at any pill repeat prescription appointment, once the doctor knows that the hormones are being well tolerated, it would save thousands of unwanted pgs.

Goofymum Tue 22-Apr-14 00:01:58

Often a trial of the pill is given first for that reason ponkypink. A lot of teenagers take condoms from schemes run across the country. It doesn't guarantee their use. The uk still has too high a teenage pregnancy rate and repeat abortion rate. The best way to stop an unwanted pregnancy, especially in young girls, is with a long acting contraceptive like the implant. Girls should be counselled effectively beforehand including the side effects. Some women will have bad side effects and then the implant can be removed. For a lot of women it's fantastic. 3 years of not having to worry about remembering to take the pill. Doesn't protect against stds of course.

BeyondTired Tue 22-Apr-14 00:58:22

Umm... Percentages arent cumulative...

Anyway though, a lot of people don't get on with the implant, even those who are fine on the pill. And I love my mirena, but would never say everyone should have one.

lubeybooby Tue 22-Apr-14 01:14:31

nope... so much nope. all the nope.

I found it hellish and wouldn't want to subject a teen to it who is barely used to all the hormones going on as it is. It made me very unstable and anxious.

If it were recommended they would need to be more honest about the side effects and not be so reluctant to remove them.

DioneTheDiabolist Tue 22-Apr-14 01:21:46

I wish they'd get a move on with non barrier/non permanent contraception for men.

Sorry, don't mean to derail, but I had to say it.

PickledEggMobile Tue 22-Apr-14 01:24:44

Before I had my implant my dr gave me the pill that had the same type of hormones in. Might have been cerazette but I'm not sure. I was on them for a month then had my implant. No adverse side effects.

I hated remembering to take a pill and never felt quite safe.
The failure rate of implanon, the previous implant was not that they didn't work but that women were told it was in when in fact it had failed to come out of the injection thingy <insert proper medical term here!> so we're never covered in the first place.

I love feeling the little rod in my arm knowing it's there hopefully doing its job, and I wish I'd known about it sooner rather than wasting years on the pill, having to set my alarm on my phone to make sure I remembered to take it.

TOADfan Tue 22-Apr-14 02:18:57

I had the implant at 18 but I got it took out after 6 months of constant bleeding. I got it due to forgetting to take my pill everyday, so yes it worked for that but the side effects weren't worth it. My BF has the same sode effects.

Me and my DP can't have children and one thing im happy about is that I will never have to use a hormone contraceptive again! though we are using condoms atm to ensure this atm

ICanSeeTheSun Tue 22-Apr-14 06:17:38

I am so glad that I don't have to worry about contraception ever again.

A young women should be encouraged to use a contraception she feels comfortable with. With barrier methods being made clear is important to.

I was a virgin when I met DH, but we both went to the GUMm clinic before we ditched the condoms.

JessieMcJessie Tue 22-Apr-14 06:53:23

The patch is a good happy medium-you stick it on and forget about if for a week, so all you have to do is have a routine of chamging it on, say, a Monday morning. Super sticky, won't budge through showering or swimming.

slowcomputer Tue 22-Apr-14 07:15:12

The patch isn't all that great, it is a combined pill in patch form so those who have medical issues with the combined pill can't use it, the risk of blood clots is higher and it is often easier to forget something that is once a week than every day. The implant is cost effective even if removed after one year and we (I'm a GP) promote it a lot, but a third of women have it removed for troublesome bleeding and there are lots of urban myths out there stopping people having it.

MrsMook Tue 22-Apr-14 07:24:42

Another implant fan. I had a trial of cerazette for a few months too. It's great for me as it reduces painful periods, and I'm forgetful at taking the pill. Where the hormone blend is suitable, the element of user failure is very low. I went on the pill two years before I needd any contraceptive benefits to manage painful periods.

ThePassionOfHoneydragon Tue 22-Apr-14 07:29:44

Condoms have a 100% better chance of preventing sti's than the implant though

BertieBotts Tue 22-Apr-14 07:30:16

How old are you op? In my area it was all the pill when I was a teenager but that's nearly 10 years ago now! 6 years ago when I was 19 they were really heavily pushing the implant and I didn't want it, they suggested i try the equivalent hormone in pill format, and then ignored me when I said I had bad side effects. Went to the gp and she was shocked and said stop immediately. I was bleeding non stop and anaemic.

Most young people I know in my area are on the implant.

BertieBotts Tue 22-Apr-14 07:35:42

And it's taught about in schools, and every time I get a repeat pill prescription it flashes up on the doctor's computer "Ask patient about LARC"

BertieBotts Tue 22-Apr-14 07:39:18

To the person who said only give condoms -LOL. Teenagers are fucking stupid. I would have been pregnant far earlier to even less suitable bloke! Condoms are a pain in the arse, hate using them now!

KeepOnKeepingOnAndOnAndOnAndOn Tue 22-Apr-14 07:56:54

I had the implant and basically bled non stop for six months. I had the coil and bled non stop for over six months. The pill may not be as effective, but ime and friends - it is the least problematic in terms of side effects (except pregnancy!) - i do feel being in the pill is a gamble. You get little side effects, but risk of pregnancy is higher. I know so many who have fell pregnant on the pill too...
I think it is a tough one, OP...

sooperdooper Tue 22-Apr-14 08:03:11

The injection and implant both sent me loopy, I think it's good to have options but some contraception doesn't suit everyone

BertieBotts Tue 22-Apr-14 08:13:01

Pill is 98 or 99% with perfect use. And most "I got pregnant on the pill!" stories always seem to be "Oh but I was sick/had diarrhoea/was on antibiotics". If you know the things to avoid and what to do if you come up against these situations then it is far more effective.

NomDeClavier Tue 22-Apr-14 08:13:30

I think long term hormonal contraceptive is risky for teenagers and even some women into their twenties. Hormones and brain chemistry just haven't settled down sufficiently and what works in terms of wellbeing for a few months can stop working fairly rapidly.

All forms of hormonal contraceptive send me loopy. We now use NFP and I'll be teaching DD about NFP as soon as she's old enough in case she can't tolerate the pill in its various forms either (though I won't stop her trying it if she chooses).

As an aside I think teenage girls need a lot more support about relationships, contraception and sex ed on general. The pill has done women's liberation as much harm as good. You can shag around without necessarily getting pregnant but it's also a way for men to control women and coerce them into sex (because after all they won't get pregnant).

AuntieStella Tue 22-Apr-14 08:20:55

OP: how old are you?

I have teens, and friends with DC in teens early 20s now, and among those who know their girls' contraceptive choices they are all on implant (if they have moved on from condoms).

ImAThrillseekerBunny Tue 22-Apr-14 08:40:49

98% is not that great Bertie. Not for something really important like this if you aren't prepared to use abortion as a fallback. One of my big beefs about contraception stats is that they're always presented in terms of success rates rather than failure rate, and people mentally class anything over 90% as "pretty damn good." A failure rate stated as 1:20 per year is much more obviously a lot worse than 1:500.

ImAThrillseekerBunny Tue 22-Apr-14 08:46:31

(Yes I know that 98% is 1:50 not 1:20 - I'm thinking of Persona which advertised itself as being 94% effective and then had a load of women shocked when they conceived using it).

JessieMcJessie Tue 22-Apr-14 08:47:40

slowcomputer isn't the implant also a combined pill with a different delivery method - cf posters here who say they were given Cerazette as it had the same hormones as the implant? I am not challenging you, as you obviously have professional training; am genuinely interested in the difference. And as for blood clot risk, aren't teenagers fairly low risk for that anyway, as long as they are not overweight, smokers or otherwise predisposed to that risk? From what I understand, the patch is not favoured by GPs because it's expensive.

ImAThrillseekerBunny Tue 22-Apr-14 08:48:58

No, implant is minipill hormone hence suitable for women at risk of clots.

The implant made me bleed for a year, minus 5 tiny days here and there, played havoc with my hormones, made me depressed and contributed to me gaining about 2 stone. Oh and the doctor wouldn't take it out because it was too expensive to have wasted. I ended up crying all over a clinic nurse and begging, saying I wouldn't leave until they removed it.

So I do think teens-as with everyone-should be given options, but I don't think the implant should be the number 1 option that's suggested to them. I know several people who've reacted really badly to it. If you react badly to the pill you can stop taking it. With the implant you're at the mercy of the NHS.

EhricLovesTheBhrothers Tue 22-Apr-14 08:54:51

Teenagers are encouraged to have LARC as part of the teenage prevention strategy. Usually this is the injection although the implant is heavily promoted. I agree that the pill isn't fit for purpose for many teenagers.

thebodydoestricks Tue 22-Apr-14 09:01:59

This is so interesting.

My teen dd started the pill last month primarily to rationalise her periods but also as a contraception.

We are now thinking if the implant as it would take the worry out of taking the pill however nothing is perfect is it and it's a case of try and see.

Sorry a bit confused about expense of the implant. In the UK it's free to teens isn't it? Under 18s?

weatherall Tue 22-Apr-14 09:03:18

All the young women I know are on the implant.

I don't think there are enough voices saying that it's important to double up and use confoms too though. Why is it seen as either/or?

Afaik in Holland they routinely use both (hormonal and condoms) and have very very low teen pg rates.

thebody it's free for the patient but an expensive option for the NHS.

NomDeClavier Tue 22-Apr-14 09:18:42

It is free but costs the NHS time to insert plus the device plus time to remove. Over a year that is less than the pill, particularly factoring in repeat appointments, but more under (I believe). The Mirena is not recommended unless you want to leave it in for 2 years as otherwise again the pill is more cost effective. In other countries where it's not solely funded by the state there is much less reluctance to trial these expensive options.

BertieBotts Tue 22-Apr-14 10:31:28

Well what is stronger than 99% Bunny? That's what I was always told the pill is. Yes it's not perfect but I don't think anything else is either - in fact condoms are only 97% or something like that so slightly worse.

Probably is safest to double up but that was always seen as unnecessary and overly paranoid when I was a teenager.

TBH though I wanted a baby when I was a teenager so I was never that careful anyway. Teenage minds are pretty irrational.

BertieBotts Tue 22-Apr-14 10:37:41

Having looked up that wikipedia article:

Combined pill/mini pill (same numbers) - perfect use 99.7% typical use 91%
Condoms - perfect use 98%, typical use 85% (!!!)
Implant 99.95% - no margin for error.

Obviously the implant is better but as stated above it's not suitable for everyone. The pill is effective enough for me. I am confident I am closer to perfect than typical use.

jaysaway Tue 22-Apr-14 10:45:57

I conceived on the depro injection hmm i was in my 20s though I do think it is recommended younger women take the pill/use condoms o the implant is more a long term not wanting any more babies contraceptive,

FrankUnderwood Tue 22-Apr-14 10:48:40

It's free to patients but the cost to the NHS is much higher than the pill.

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