GP advises Contraceptive Implant or Mirena Coil when I'm happy on the pill

[pumasalient]

Hi
I went to see my GP this morning for a prescription review and he asked me why I am on the combined pill when it would be better for me to be on either the contraceptive implant or the Mirena Coil. I am 34 years old, have low blood pressure and am very happy on the pill. He started citing that pill users have a higher increase of breast cancer and blood clots etc etc. It took me by surprise and made me a bit worried. I have no problems being on this particular pill (others in the past haven't suited me) and I REALLY don't fancy either of these alternatives. In the leaflet he gave me it said that 1 in 20 women suffer from displacement with the coil and may not realise which of course could cause pregnancy. Has anyone else been to their GP and had a similar experience? I wondered if Drs receive any kind of payment when women have these fitted?
Thanks

I often wonder the same thing. I'm in America, and have moved several times, and each OBGYN have tried to get me to switch, and I stubbornly refuse, because I know (actually know, not know of) 4 people who have had their Mirena break through the uterine wall and have had to have surgery to get it out of places in their body that it wasn't supposed to be.

My GP told me that they "push" them as an alternative to the pill as it is significantly cheaper. I just said thanks but no thanks I'll stick with what I'm doing as I plan to have another Dc in a year or so (lies complete lies!) and he merrily signed off my pill

LARC (long acting reversible contraceptives) are promoted as they tend to be more reliable and safer, especially for women in their 30s.

The GP will receive payment for fitting them but they don't 'profit' from them as the devices themselves aren't cheap and the staff fitting them have to be trained up and updated/assessed/audited.

It's been mentioned every time i go for a pill check. Does piss me off a little but i guess everyone's got targets these days.

No, there is no payment for these methods.
AFAIK they are not cheaper than most pills.

There is a government initiative to 'encourage' longacting reversible contraception (LARC) in an attempt to reduce rates of unwanted pregnancies and termination.
For every contraception review GPs are ment to 'offer' LARC. Every bloody time. Even if we know fine that somebody is perfectly happy with their chosen method and that there is no medical reason that might force a change ie high blood pressure/age/smoking.

We are also ment to enquire after any change of partner since last seen, remind about barrier contraception, inquire about possible domestic violence, counsel about the dangers of multiple partner/less safe practices etc etc etc.

Jesus wept!!

I am perfectly happy to prescribe whatever a woman choses to use for contraception but will go into some detail about available methods if somebody comes for the first time or asks.

Don't lie to your drs, just say you are happy on whatever you are on. We might all have our own preferences, but they should really not come into it when talking to you.

Please don't think I am criticising doctors for promoting long term contraceptives. I appreciate that for many women these are good options. My personal concern is trying to understand all the alternatives and the particular risks (in all their formats) associated with each form of contraception. From the research I have done since I got home if may be that it would be better for me to switch to the mini pill (I am fastidious about my pill taking so the 3 hour window does not put me off!). However, I also understand that there are increased risks of certain types of cancer which of course concerns me. Unfortunately the only 'safe' answer is no contraception and no sex but I don't think this would suit either me or my husband!

Cerazette is the most commonly used progesterone only pill as it has a 12 hour window just like combined pills.

I am sorry I at you, puma, bad day at the office.
I just sometimes feel I'm damned if I say too much, damned if I don't say enough about stuff.

What are the pros and cons of the implant?

The big pro of the implant is that the risks of pg are absolutely minute - far less than any other method with the possible exception of vascectomy. You might also not get periods. If you don't suffer side effects then that rock solid protection is a huge benefit

Implant

Also, fertility returns very quickly after removal of an implant (within 30 days).

What effects do the barium in the implant have on the body?

AFAIK the barium is inert and simply there to allow the implant to be visible on x-rays. Why do you ask?

I've always understood that barium enemas were to be avoided unless absolutely necessary, because you wouldn't want barium hanging around in your body.

Eh?
The barium from barium enemas you poo out again. It only hangs about in constipated people and then can be irritant. Ba enemas (and swallows) are a commonly used test to look at the large bowel or gullet in people who for whatever reason cannot have an endoscopy.

In the implant it sits there for 3 years (or however long you want it in) and then gets taken out. It's not radioactive or anything, and does not get absorbed.

Just say no if you're happy with what you are using and you do not have a medical condition which makes you unable to use it any longer.

I thought it was radioactive.

Nope, just radio opaque. Personally, I'd not worry about it (and haven't in the past )

Think the PIP implant scandal has shown that we should try to find out what's being implanted in our bodies?

Then it's a simple matter of, if you don't want it, say NO. They can't force you to get one.

I had the hard sell with the Mirena. It was a disaster for me.

So was Cerazette.

Progesten-only contraception and I are not a good mix.

Yes, it's the teen dc I'm worried about. Much harder for them to say no to a GP.

That's why a good GP should offer options. And then it's the woman's/girl's choice.

I get a lot of teenaged girls who come in wanting 'the pill'. A lot of them have no idea that there are other options. And pills only work if taken...

Different methods agree with different people. Sometimes you just have to try them out. I liked Implanon aka Nexplanon (new name). And I liked combined pills. And now I am liking a good old-fashioned copper coil .

Some interesting points made here.

(I found that site by googling - it's nothing to do with me.)

I prefer vasectomised husband. :o

Oh dear, also found this by googling.

You can find a lot of stuff on Google.