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Implant-related bleeding — DFSRH MCQ

Instant feedback + full explanation. One question, done properly.

HardProgestogen-only methodsImplant-related bleedingDFSRH

An etonogestrel-implant user has bothersome unpredictable bleeding. Pregnancy, infection and cervical pathology have been excluded, and she is medically eligible for CHC. Which management is reasonable if she wants to keep the implant?

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

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Correct answer: E — Offer a short course of combined hormonal contraception

The best answer is “Offer a short course of combined hormonal contraception”. After excluding other causes, a short CHC course can be considered for implant-related bleeding when medically eligible. Removal remains available whenever the user wants it but is not compulsory. Unscheduled bleeding does not imply loss of contraceptive effect, and antimicrobials or a second device are not indicated without another diagnosis.

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