skip to main content

Implant unscheduled bleeding — DFSRH MCQ

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

HardProgestogen-only methodsImplant unscheduled bleedingDFSRH

A 32-year-old has had an etonogestrel implant for 9 months and presents with new irregular bleeding after a new partner. Pregnancy test is negative; speculum examination shows a normal cervix with mucopurulent discharge. What is the most appropriate investigation?

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

Reveal the answer and explanation

Correct answer: A — Vaginal NAAT for chlamydia and gonorrhoea

Bleeding is common with implants, but a new pattern with a new partner and discharge requires STI testing. Pregnancy has been excluded, and the cervix is visible and not suspicious. Assuming implant bleeding without assessing infection would miss a common, treatable cause.

Reference: FSRH Guideline Progestogen-only Implant; BASHH STI Testing Guidance