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Expired implant and UPSI — DFSRH MCQ

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HardProgestogen-only contraceptionExpired implant and UPSIDFSRH

A patient with an implant in situ for 18 months develops new heavy bleeding and pelvic pain after previously regular bleeding. What is the most appropriate initial action?

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

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Correct answer: A — Replace implant for a bleeding-pattern change

A marked change in bleeding with pelvic pain needs assessment for pregnancy, infection and other pathology before attributing it to the implant or choosing treatment. Management can then be tailored to findings and contraceptive preference.

Reference: FSRH, Progestogen-only Implant guideline: https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-guideline-progestogen-only-implants.pdf