GP cash incentive to promote long acting contraceptives

This is very interesting to me. I had 2 copper coils; with each coil I had pains off and on for 6-9 months until it dislodged and had to be removed. The only HCP who believed that my pain was caused by the coil was the nurse at the walk in family planning clinic who removed the 2nd coil. GP / Gynaecology both denied that they had ever heard of a woman experiencing pain from a coil.

I had to bleed non-stop for a year before my GP would remove a mirena coil on the grounds of its expense. I seem to remember not being terribly impressed.

Or you're given the Pill or similar to cope with constant bleeding on the Mirena or offered anti-depressants if it sinks your mood out of nowhere.

Mirena killed my libido like never before. I was told it would 'settle' and to carry on with it, because who cares about a woman's desire for sex?

I didn't even have it for bad periods but as contraception. It was fabulous for that!

My teenage daughter was continually hard sold LARC every single time she saw a GP or nurse for anything. She told them she is a devout Christian who doesn't believe in sex before marriage (true). She was told she still 'needed' LARC in case she was raped. She complained formally. They have since stopped. Teenage women are seen as stupid, amoral, uneducated creatures who are incapable of making any good decisions about themselves and their own bodies by the health service here.

Ugh. I'm so sick of how I've been treated for hormonal/contraceptive issues. Endless bloody gaslighting about how they don't cause side effects and mirena is localised progesterone so can't cause side effects. Which isn't true. A choice of hormonal contraception (which makes me feel miserable and apathetic 100% of the time) or antidepressants for perimenopausal issues. I've been taking ADs for 5 years,now I can't get off the bloody things.
Totally fed up of women's cycles being seen as something we have to just live with if we can't take hormones.
While flipping viagra is funded to the hilt cos penis needs.
I don't blame GPs but the way womens health is dealt with is patriarchy in action imo

What is the process with reporting side effects of these contraceptions? I was put off getting the implant as a number of my friends reported similar issues. When I said so to the doctor she said that none of those issues were linked to the implant. My friends tried to report the same side effects to their doctors and were dismissed and told they weren't linked to the implant.

Now possibly it is a coincidence that all of my friends had the same issue, but how can it be confirmed unless data is gathered? Essentially the women experiencing the side effects are ignored, so the women considering the implant are not informed of the real possibilities.

On my online medical notes one of my medications is listed as the contraceptive injection. I’ve never had the injection but vaguely remember it being mentioned to me a few years ago.

After hearing stories of side effects that you’re stuck with until the injection wears, and a reluctance from some HCPs to remove things like coils I’d never use LARC.

The real scandal is that women have to see GPs for contraception of any sort. So many other countries have direct access to gynaecologists for women’s health- smear tests, contraception, pregnancy care, breast checks, menopause, etc. I think millions of women’s lives would be dramatically improved if they had direct access to a specialist gynae and I don’t believe it would be much more expensive for the NHS.

I can assure you that is not why I and my colleagues sacrificed our youth working 100 hour weeks as trainees!

You sound like you think you're owed something for the career choice you made. No one forced you to enter into the career your chose, you made that decision of your own volition as an adult, knowing what the training involved and with the ability to leave it at any time. It was in no way a sacrifice. What insulting and presumptive language.

I had a hell of a time getting my Mirena removed. Finally had to do what EarthSight suggested and state that I no longer consented to the treatment but this consent was being removed from me.

There is zero way a man would ever be treated in such a way.

£700 per practice per year - it's not going directly into the GP's salary and it's hardly going to keep them in printer paper for the year.

Split across all the staff in the surgery - GP partners, salaried GPs, nurses, receptionists, cleaners, etc as that £700 is going into the business not one person's back pocket - it doesn't add up to much does it?

And no for the billionth time, v few GPs are getting £100K a year and there is a massive recruitment crisis in GP training. Possibly if they were getting £100K people would be keener to do it.

The 2009 introduction of incentives for 'counselling' on LARC was covered in some depth on Womans Hour this morning.

I think if they are looking for reasons why women do not take it up or continue with it, they should come along to Mumsnet. There have been many threads of women who feel pushed onto facing barriers to getting help with unwanted side effects or getting the device removed.

They started the piece saying contraception gives women control over their fertility, but it is obvious that it is lack of control with LARCs that is the problem.

I’m largely in favour of my mirena, it’s been in place for nearly 4 years now and has been pretty good. I have a breast lump, however, that changes with my hormone cycle, and I think might be mirena related (it’s been examined twice by ultrasound now and is apparently fine). So for this reason I would like it removed to see how I get on. But getting it removed is nigh on impossible - there are a limited number of appointments that can only be secured by calling at 8am on a Thursday or something silly like that. It’s a time I can’t ever quite manage because of school drop off etc. I’m not desperate to have it out so I’m fine but the barriers to getting it out are huge. And it has to be done at the sexual health clinic (the GP won’t do it). The strings are gone, so it’s not going to be simple to get out. So yes, my experience was very straight forward to put in, very difficult to remove.

Graphista, GPs are not pinning down struggling teenagers and forcing implants into their arms! They’re telling them about the most reliable method of contraception, obtaining consent and then inserting it. The resulting reduction in abortion rate represents a huge benefit - both in less teens going through the potential emotional trauma, and cost to the NHS. This is a win/win.
It is sad that you seem so mistrustful of doctors that you prefer to think we are all in some money making scheme to damage women’s health. I can assure you that is not why I and my colleagues sacrificed our youth working 100 hour weeks as trainees!

GP,s have always had incentives for almost everything they do, they get paid for discussing contraception let alone providing it.

Yep. I'd have been annoyed...unless they were just double-checking you knew the ramifications. :/ health care for women generally isn't great. It still takes women longer to be diagnosed etc. I listened to an interesting radio programme talking about women and apparent hysteria, and how that is taking so long to die in the medical profession. The history of it all was fascinating. So yes, it's not great, but as per the op I think woven should be informed. Good practice I'd have thought.

@housemdwaswrong yeah I knew my options, and talked through them in a previous appointment and then went to family planning to have it fitted. I booked for a copper one, confirmed I wanted the copper one and they were still "are you sure, mirena will make your periods better?"
Well yes but I'll also be a hormonal wreck so on balance I'll take the periods!

@queenpaws See, now that I'd be v. annoyed about. But sat in a consulting room discussing options I'd expect to be told all the options.

I wanted a copper coil. They were still offering me a mirena while I was on the bed with a speculum in. No thank you, I'll take the not hormonal one, I have enough of my own hormones

Why is advising women who have previously taken contraceptives including the map a bad thing? If women have been pressurised that's wrong, of course, but down to their individual GP.

I take various prescription drugs, and am advised about long term effects, potential alternatives etc. I can't see the difference.

Now if they were getting money paid by switching me to different drugs I'd certainly have an issue. But being advised of different drugs that may suit better is a good thing. GPs should be doing this routinely. I find it rather bizarre that they had to be encouraged to do so.