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Unscheduled bleeding on implant — DFSRH MCQ

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ModerateProgestogen-only contraceptionUnscheduled bleeding on implantDFSRH

A 24-year-old implant user reports irregular bleeding for 3 months. She has a new partner and mild pelvic discomfort; her pregnancy test is negative. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — STI testing with clinical assessment for pelvic infection

Bleeding can occur with the implant but new bleeding with STI risk or pain needs infection assessment. Immediate removal is not necessary before assessment unless requested. Method-related bleeding is a diagnosis after excluding relevant pathology.

Reference: FSRH Progestogen-only Pills Guideline; FSRH Progestogen-only Implant Guideline; FSRH Progestogen-only Injectable Guideline; UKMEC 2025; BNF