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Implant bleeding — DRCOG MCQ

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HardContraceptionImplant bleedingDRCOG

A woman has irregular bleeding three months after contraceptive-implant insertion. She is otherwise well but has had a new sexual partner. What is the most appropriate initial assessment?

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Correct answer: D — Assess pregnancy risk, STI risk and other bleeding causes

The best answer is “Assess pregnancy risk, STI risk and other bleeding causes”. Unscheduled bleeding is common with the implant, but assessment should be guided by the history and include pregnancy and STI risk, adherence to relevant medicines and symptoms suggesting another cause. Once concerning causes are excluded, explanation, reassurance and method-specific management can be offered. Automatic removal, blind antibiotics or dismissing the history is not appropriate.

Reference: FSRH: Problematic bleeding with hormonal contraception: https://www.fsrh.org/standards-and-guidance/fsrh-guidelines-and-statements/problematic-bleeding-with-hormonal-contraception/