Patient Information
Patient Privacy
Une Femme Women’s Health Clinic takes patients privacy very seriously, particularly in light of the sensitivity nature of the procedures performed.
It is the policy of Une Femme Park Women’s Health Clinic that all efforts will be made to maintain patient privacy while attending the clinic and all records are kept securely in accordance with privacy principles.
Privacy Compliance
Une Femme Women’s Health Clinic is bound by the National Privacy Principles (Privacy Act 1998, as amended). Une Femme Women’s Health Clinic deals with personal information in accordance with such principles.
The National Privacy Principles can be obtained through the website of the office of the Federal Privacy Commissioner (http://www.privacy.gov.au).
Information Collected by Une Femme Women’s Health Clinic
Patient Information
Une Femme Women’s Health Clinic holds the following information with respect to its patients.
- Name
- Personal address
- Postal address
- Next of Kin
- Telephone number
- Fax number
- Date of birth
- E-mail address
- Medical History
- Treatment plan and treatment details
The purpose of the above information is to enable the clinic to effectively treat patients. Your personal information is shared with other health professionals (only when necessary) as part of your ongoing care.
The following table lists a comparison of Short Acting Contraceptive Options
|
CONTRACEPTIVE
|
COMBINED CONTRACEPTIVE PILL
|
CONTRACEPTIVE RING
|
MINI PILL
|
|---|---|---|---|
|
WHAT IS IT?
|
A small pill taken every day that contains both estrogen and a progestogen
|
A small plastic ring; a little larger than a 50 cent coin that is inserted into the vagina. It contains the same hormones as the pill.
|
A small pill taken at the same time every day of the month that contains a progestogen only. *There in a new P2 only pill also available called Slinda.
|
|
HOW LONG WILL IT LAST?
|
You need to take a pill each day within 12 hours of the normal time. In each pill packet there are 3 weeks of hormone tablets and one week of sugar pills.
|
Once inserted into the vagina it should stay inside for 3 weeks then be removed for one week before inserting the next ring.
|
Needs to be taken at the same time each day. Not reliable if taken more than 3 hours late
|
|
HOW DOES IT WORK?
|
The combined contraceptive pill prevents ovulation and fertilization.
|
The hormones are directly absorbed into the blood stream from the vagina and work like the contraceptive pill to prevent ovulation.
|
The mini pill prevents sperm from entering the uterus by increasing the mucus in the cervix and prevents implantation by changing the lining of the uterus.
|
|
EFFECTIVENESS?
|
In real terms we see approximately 1 to 2 women out of every hundred fall pregnant each year.
|
Same effectiveness as for the contraceptive pill.
|
Allowing for human error it is quoted that out of every 100 women 2 – 8 will fall pregnant.
|
|
ADVANTAGES
|
There are many different pills on the market allowing variation and choice. Some pills help with acne and polycystic ovarian disease. Will often decrease period bleeding and pain. Can be stopped easily.
|
50 % less nausea than compared to the combined pill. No need to remember tablets daily. As it is absorbed straight into the blood stream, not effected by diarrhea like the combined pill is.
|
Safer for women who smoke and for women who suffer migraines. Safe for women breast feeding in first 6 months. Safer for women over 40 years old and those who have elevated blood pressure.
|
|
DISADVANTAGES
|
You need to remember to take the pill each day. Risk of stroke/ blood clots (DVT) in patients who smoke and are over 32 years old. Can be affected by vomiting, diarrhoea and some antibiotics.
|
Some women may not like to insert the ring. It can be effected by some antibiotics.
|
Need to take it at same time each day otherwise you can have spotting and it might fail. It can be affected by severe vomiting or diarrhoea. Some medications can change its effectiveness (epilepsy medications.)
|
|
WILL IT CHANGE MY PERIODS?
|
The combined pill often regulates the period to every 28 days. It can make the bleeding lighter and period pain less.
|
This often provides excellent control of period bleeding where the combined pill has not been able.
|
You might have irregular bleeding, spotting or no period at all.
|
The following table lists a comparison of Long Acting Contraceptive Options
|
CONTRACEPTIVE
|
DEPOPROVERA
|
MIRENA/KYLEENA IUD
|
COPPER IUD
|
IMPLANON
|
|---|---|---|---|---|
|
WHAT IS IT?
|
Depo-Provera is a long-acting contraceptive containing medroxyprogesterone acetate.
|
Is a small “T” shaped plastic device containing a progestogen Mirena has 52 mg and Kyleena 19.5 of progesterone (LNG)
|
Is a small plastic and copper device that is inserted into the uterus by a trained doctor. Copper IUD – there is a 5 year and 10 year copper IUD available.
|
This is a small matchstick sized device containing progestogen that is inserted into the skin of the upper arm.
|
|
HOW LONG WILL IT LAST?
|
Each injection lasts for three months. It must be given into the gluteal muscle by your local doctor.
|
Mirena lasts for 7years Kylena last for 5 years. Either can be removed earlier.
|
Can stay in the uterus for 5 years then needs to be replaced. Can be removed earlier
|
Needs to be replaced every 3 years but can be removed earlier.
|
|
HOW DOES IT WORK?
|
It helps prevent ovulation, thickens cervical mucus and thins the lining of the uterus to prevent implantation.
|
It will change the lining of the uterus, making implantation difficult and also increase cervical mucus, preventing sperm from entering the uterus
|
The copper in the IUD causes a chemical reaction in the lining of the uterus to make it not suitable for fertilization and implantation.
|
The implant continuously releases a small amount of progestogen to prevent ovulation, and increase cervical mucus.
|
|
EFFECTIVENESS?
|
When taken correctly failure rates are as low as 0.5 % (one in 200).
|
Less than one in 1000 women will fall pregnant. Kyleena one in 500 Efficacy: Mirena is 1/1000 Kyleena is 1/500
|
One in 100 women will fall pregnant each year
|
Less than one in 1000 women will fall pregnant.
|
|
ADVANTAGES
|
Highly effective. Easy- no pills to remember. Nothing interferes with it working. Inexpensive. Safer for women unable to take estrogen (e.g. smokers)
|
Very effective for women with very heavy periods as designed to lighten bleeding. Nothing interferes with it working. Safe option for women unable to take estrogen. Can be used during breast- feeding.
|
Provides an effective option for women unable to take any hormones, provided their periods are not heavy.
|
Is a good option for women who find remembering the pill difficult and who have not had a child. Can be removed if side effects occur.
|
|
DISADVANTAGES
|
Once injected it cannot be reversed, so if you have side effects (weight gain, mood swings, headaches, irregular bleeding) you need to wait until they wear off. There can be a delay to return to fertility of up to one year
|
You need to have it inserted by a trained doctor / gynaecologist. In a woman who has not had a baby an analgesia and or sedation if requirement May cause cessation of periods.
|
You need to have it inserted by a trained doctor/gynaecologist. Not suitable for women with a history of heavy or painful periods.
|
Needs to be inserted by a trained doctor. Some women (20%) will experience weight gain. Acne and mood swings also possible.
|
|
WILL IT CHANGE MY PERIODS?
|
50 % of women will stop having periods. Some women will have unpredictable spotting / bleeding which will often settle after 3 months or your second
|
Many women will experience spotting /irregular light bleeding for first 3 months which normally settles.
|
Period bleeding can become up to 40 % heavier and period pain might increase.
|
Approximately 30 % of women will have a normal period, 30 % will not have any periods and 30 % will have irregular bleeding for first 3 months (of which half will settle down)
|
What is a Copper IUD?
A copper IUD is a small device with a fine copper wire wrapped around a plastic frame. It’s placed inside the uterus to prevent pregnancy. A fine nylon thread is attached to the IUD. The thread comes out through the cervix into the top end of the vagina. There are two types of copper IUDs available in Australia – one lasts for
5 years and the other for 10 years.
How does the copper IUD work?
The IUD is placed inside your uterus by a doctor.
The copper IUD:
• is toxic to the egg and sperm which stops sperm from fertilising the egg
• slows the transport of the egg to delay chance of sperm and egg meeting
• changes the lining of the uterus to make it unable to support a fertilised egg
How well does the Copper IUD work?
The copper IUD is 99.5% effective.
Who can use the Copper IUD?
• most women who want a reliable, long term contraceptive
• women who haven’t had a pregnancy, have completed their families, or are spacing their pregnancies
• women who are breastfeeding
• women who cannot, or do not want to, use hormonal contraception because of medical conditions preference
When you should NOT use the Copper IUD?
• you think you might be pregnant
• you have had a recent infection called pelvic inflammatory disease (PID)
• you have unusual bleeding from your vagina
• you have Wilson’s disease or you are allergic to copper
When to talk to your Doctor before having the Copper IUD
• if you have painful or heavy long lasting periods
• if you have anaemia (not enough iron in your blood)
• if you have had a recent sexually transmissible infection (STI)
• if you have fibroids or other conditions that change the shape of your uterus
• if you have had problems in the past with an IUD (for instance it has come out by itself)
• if you are unable to have a follow-up check-up after the IUD is put in Advantages
• It’s very effective • It can stay in place for 5 or 10 years depending on which one you choose
• The initial cost of a coper IUD is more than for other methods, but it lasts for 5 or 10 years so it works out to
be a reasonable price • It does not contain hormones so it has no hormonal side-effects
• Your fertility goes back to normal straight away when you take it out
• It can be used as emergency contraception if it is put in up to 5 days after unprotected sex
Disadvantages
• It doesn’t protect against sexually transmissible infections (STIs)
• It requires a procedure to be put in and removed from the uterus; putting it in can be uncomfortable
• When the IUD is put in there is a small chance of: –
- difficulty inserting the IUD damage to the wall of the
- uterus infection
- It can sometimes come out by itself
- Your periods can be heavier and last longer
- You can have some irregular spot bleeding in the first few months
How do I get a Copper IUD?
Only a specially trained doctor or nurse can put in an IUD. You may need to make two visits.
- the doctor and/or nurse will ask questions about your health
- you might have a vaginal examination, a cervical screening test or a test for infection
- putting the IUD in takes about 10 minutes
- you may find it uncomfortable or painful and some women feel faint
- you can have a local anaesthetic. Some women have the IUD inserted under sedation. We are able offer pain relief to make your experience more comfortable.
After your Copper IUD is put in
- you may have cramps and bleeding or spotting in the first few days
- avoid sex, tampons, swimming and baths for 2 days to reduce the risk of infection
- go back for a check-up 4 to 6 weeks after the IUD is put in
- check the IUD threads each month after your period to make sure the IUD is still in the right place Things to remember with your Copper IUD
- check the threads each month after your period to make sure the IUD is still in the right place if you have any unusual symptoms (discharge from your vagina, pain low in your tummy or deep pain during sex) see your doctor straight away
- if you are worried you could be pregnant, have a pregnancy test
- if you or your partner have a new sexual partner, use a condom every time until you both have been checked for STIs
- keep a record of the date to take out your IUD – it shouldn’t stay in for longer than the recommended time
Implanon
What Is It?
Implanon is a contraceptive implant device inserted under the skin of the inner upper arm. It is a soft rod which is 4cm long and 2mm wide in diameter. Once inserted it can be felt, but not easily seen.
It contains only the hormone progestogen, similar to the progesterone that occurs naturally in the body.
How Does It Work?
The main action of lmplanon is to prevent ovulation (the production and release of an unfertilised egg). It also works by thickening the mucus produced by the cervix (entrance from the vagina to the uterus), which prevents sperm from getting through into the uterus.
How and When is it Inserted?
lmplanon is inserted by Dr Kenney who has been specially trained. The insertion takes only a few minutes and is performed with local anaesthetic to minimise pain. After the local anaesthetic wears off (a few hours), there is usually some soreness and noticeable bruising, which settles within a few days. If it is inserted during the first 5 days of a period, the contraceptive implant is effective immediately. If inserted at other times of the menstrual cycle, it will be effective after 7 days. You must check with your doctor that you are not pregnant at the time of insertion.
Who Is lmplanon Suitable For?
lmplanon may be appropriate if:
- You want effective contraception, particularly if you have difficulty remembering to take pills every day.
- You have difficulties with other forms of contraception.
- Implanon is safe and used for people who have previously had blood clots
- You are unable to take contraception which contains oestrogen.
- Implanon is suitable post partum ad can be inserted straight after childbirth
Who Is lmplanon NOT Suitable For?
Generally, lmplanon is thought to be safe for most women. However, care should be taken if:
- You are breastfeeding. Although it has been studied in only a small number of mothers and their babies, lmplanon is probably safe.-remove this.
- You have a history heart disease, liver disease or take medications for epilepsy. You may still be able to use lmplanon but you need to have a detailed discussion with your doctor.
- You have had breast cancer.
What Are The Advantages?
- The hormone is released slowly and continuously into the blood stream from the implant, therefore there is no need to remember to take a pill every day. The body also produces its own natural oestrogen at normal levels.
- This means there is unlikely to be any increased risk of osteoporosis (thinning of the bones) when on lmplanon. Research is still being conducted but all the results appear to be
encouraging. - Women who suffer from premenstrual tension (PMT) may experience a reduction of symptoms and bleeding may be less painful. Generally, women have fewer bleeding days and less total bleeding, than they would with their usual periods. On removal of the implant, any side effects or contraceptive effect are quickly reversed.
What Are The Disadvantages?
The main disadvantage is irregular bleeding pattern. This is because lmplanon contains progestogen only and it is the oestrogen in ‘the (combined) pill&’ that helps to regulate bleeding.
20% of women using lmplanon will have no bleeding.
However, a small percentage of women may have a small amount of bleeding every day. Other bleeding patterns exist between these two extremes and all patterns may settle in the first 3 to 4 months. However, they are unlikely to settle if they continue after this.
About 20% of women have bleeding patterns that are unacceptable to them, and consequently choose to have the implant removed. Your doctor may advise you to leave lmplanon in for three or more months, to see if bleeding does settle and may commence you on the pill at the same time as this has been successful in stopping bleeding for some women.
Some women are quite sensitive to the hormone in lmplanon and may gain weight; some women may lose weight.
Other possible side effects are acne, breast tenderness, a lower sex drive and headaches. Importantly, lmplanon does not protect from sexually transmissible infections (STls). Condoms and dams (for safer oral sex) need to be used, as a protection against STls. Ask your doctor when you need a check for STls.
There is a very minor chance that the Implanon can move from the site of insertion and require surgical removal.
How Long Does It Last and How Effective is it?
Each lmplanon rod is effective for three years. After three years, the rod needs to be removed and replaced. Removal and insertion may be done on the same day.
When correctly inserted by a doctor trained in this procedure, lmplanon is over 99.9% effective.
World-wide, few women using lmplanon have become pregnant.
What If I Don’t Like It or Want to Fall Pregnant?
lmplanon can be removed at any stage.
Unless symptoms are severe, women are encouraged to keep lmplanon in for at least three months, as there is a good chance any side effects will settle after this.
After removal, any side effects should be reversed within weeks and most women begin to ovulate (produce eggs) soon after the removal.
Women who stop using lmplanon are therefore expected to have the same chance of falling pregnant, as women who stop using other forms of contraception.
Fertility is thought to be unaffected long term.
How Is It Removed?
The Doctor will inject local anaesthetic over the implant. A small cut is made in the skin and the lmplanon rod is removed through this. There will be a small scar but no stitches are required.
It usually takes 10 to 15 minutes and is fairly straight forward for a doctor trained in lmplanon procedures.
If the lmplanon rod is deeper than usual, which is uncommon, the procedure may take longer as it will need to be removed with ultrasound guidance. This will be done in a hospital with a specialist in this field. The doctor will discuss this with you before the procedure goes ahead.
Chlamydia
Chlamydia is one of the most common sexually transmitted infections. It is thought that up to one in ten sexually active young people have Chlamydia. If left untreated it can cause pelvic inflammatory disease, increase the risk of an ectopic pregnancy and infertility. If you are diagnosed with Chlamydia at the time of a surgical abortion then this can increase your chances of developing a pelvic infection after the surgery. It is vital that you take the antibiotics prescribed by the doctor to prevent this from occurring and to clear it from your body.
Chlamydia trachomatis is a bacteria, passed from one person to another through sexual contact (unprotected vaginal, anal or oral sex) or sharing sex toys if you don’t wash them or cover them with a new condom each time they are used. Chlamydia lives in the cells of the cervix, the urethra (the tube where urine comes out), the rectum and sometimes the throat and eye. Infected semen or vaginal fluid coming into contact with the eyes can cause conjunctivitis. Chlamydia can also be passed from pregnant women to her baby.
You cannot catch Chlamydia from kissing, hugging, sharing baths or towels, swimming pools or toilet seats. Many people infected with Chlamydia will have not have any obvious symptoms or be so mild they might go unnoticed. (70% of infected women do not have symptoms and 50% of infected men.) Symptoms in women include: pain when passing urine, an unusual vaginal discharge, lower abdominal pain, pain or bleeding when you have sex, bleeding after sex, irregular bleeding between periods. Symptoms in men include: a white/cloudy discharge from the penis, pain when passing urine, possible pain in the testicles. As many people do not have symptoms it is often extremely difficult to know how long the Chlamydia has been present if prior testing has not been performed.
If you have been diagnosed with Chlamydia it is very important that you discuss this with your sexual partner and any other possible past contacts. We encourage your partner to see their local doctor to discuss treatment. You must both be treated otherwise there is a high chance that the untreated person will re-infect the treated person. It is essential that condoms are worn until the follow up tests demonstrate that you both have a negative result.
Follow up testing is now only required in specific circumstances not for everyone and the current guidelines have gone back to doxycycline 10o mg bd for 10 days not azithromycin any more. The treatment is very effective (about 98% effective) and usually involves a single dose of two antibiotic tablets for yourself and your partner. Please notify the doctor if you are allergic to Erythromycin or Azithromycin. Please tell the doctor if you are breastfeeding or pregnant.
Chlamydia testing is very sensitive however it is possible to have the infection even when your test is negative so most doctors will treat the sexual partner of a diagnosed with Chlamydia. Once Chlamydia is diagnosed it is often important to perform further tests to assess for other sexually transmitted diseases.
We advise speaking to your local doctor or booking a general appointment to discuss this.
If you are experiencing difficulty discussing this with your partner you may access the Let them Know website where you can send an anonymous and discreet text or email www.letthemknow.org.au Note: This website is closely monitored for misuse.
Complaints
It is our aim to ensure all personnel at Une Femme work with you in a professional and caring manner.
Should you have an issue with the care provided please let us know.
A complaint can be lodged in writing, by telephone or in person. Anyone can make a complaint such as a patient family or friend.
Who is the Complaints Manager
All Complaints are dealt with via the Practice Manager. It is important that this is dealt with and your views are heard and acknowledged.
It is the Practice Manager’s role to follow up with any individual who has complained to see if they were happy with the way their complaint was handled. IF the individual with the complaint remains dissatisfied, they are advised to utilise external services such as the Health Services Commissioner.
Patient Privacy
Une Femme Women’s Health Clinic takes patients privacy very seriously, particularly in light of the sensitivity nature of the procedures performed.
It is the policy of Une Femme Park Women’s Health Clinic that all efforts will be made to maintain patient privacy while attending the clinic and all records are kept securely in accordance with privacy principles.
Privacy Compliance
Une Femme Women’s Health Clinic is bound by the National Privacy Principles (Privacy Act 1998, as amended). Une Femme Women’s Health Clinic deals with personal information in accordance with such principles.
The National Privacy Principles can be obtained through the website of the office of the Federal Privacy Commissioner (http://www.privacy.gov.au).
Information Collected by Une Femme Women’s Health Clinic
Patient Information
Une Femme Women’s Health Clinic holds the following information with respect to its patients.
- Name
- Personal address
- Postal address
- Next of Kin
- Telephone number
- Fax number
- Date of birth
- E-mail address
- Medical History
- Treatment plan and treatment details
The purpose of the above information is to enable the clinic to effectively treat patients. Your personal information is shared with other health professionals (only when necessary) as part of your ongoing care.
The following table lists a comparison of Short Acting Contraceptive Options
|
CONTRACEPTIVE
|
COMBINED CONTRACEPTIVE PILL
|
CONTRACEPTIVE RING
|
MINI PILL
|
|---|---|---|---|
|
WHAT IS IT?
|
A small pill taken every day that contains both estrogen and a progestogen
|
A small plastic ring; a little larger than a 50 cent coin that is inserted into the vagina. It contains the same hormones as the pill.
|
A small pill taken at the same time every day of the month that contains a progestogen only. *There in a new P2 only pill also available called Slinda.
|
|
HOW LONG WILL IT LAST?
|
You need to take a pill each day within 12 hours of the normal time. In each pill packet there are 3 weeks of hormone tablets and one week of sugar pills.
|
Once inserted into the vagina it should stay inside for 3 weeks then be removed for one week before inserting the next ring.
|
Needs to be taken at the same time each day. Not reliable if taken more than 3 hours late
|
|
HOW DOES IT WORK?
|
The combined contraceptive pill prevents ovulation and fertilization.
|
The hormones are directly absorbed into the blood stream from the vagina and work like the contraceptive pill to prevent ovulation.
|
The mini pill prevents sperm from entering the uterus by increasing the mucus in the cervix and prevents implantation by changing the lining of the uterus.
|
|
EFFECTIVENESS?
|
In real terms we see approximately 1 to 2 women out of every hundred fall pregnant each year.
|
Same effectiveness as for the contraceptive pill.
|
Allowing for human error it is quoted that out of every 100 women 2 – 8 will fall pregnant.
|
|
ADVANTAGES
|
There are many different pills on the market allowing variation and choice. Some pills help with acne and polycystic ovarian disease. Will often decrease period bleeding and pain. Can be stopped easily.
|
50 % less nausea than compared to the combined pill. No need to remember tablets daily. As it is absorbed straight into the blood stream, not effected by diarrhea like the combined pill is.
|
Safer for women who smoke and for women who suffer migraines. Safe for women breast feeding in first 6 months. Safer for women over 40 years old and those who have elevated blood pressure.
|
|
DISADVANTAGES
|
You need to remember to take the pill each day. Risk of stroke/ blood clots (DVT) in patients who smoke and are over 32 years old. Can be affected by vomiting, diarrhoea and some antibiotics.
|
Some women may not like to insert the ring. It can be effected by some antibiotics.
|
Need to take it at same time each day otherwise you can have spotting and it might fail. It can be affected by severe vomiting or diarrhoea. Some medications can change its effectiveness (epilepsy medications.)
|
|
WILL IT CHANGE MY PERIODS?
|
The combined pill often regulates the period to every 28 days. It can make the bleeding lighter and period pain less.
|
This often provides excellent control of period bleeding where the combined pill has not been able.
|
You might have irregular bleeding, spotting or no period at all.
|
The following table lists a comparison of Long Acting Contraceptive Options
|
CONTRACEPTIVE
|
DEPOPROVERA
|
MIRENA/KYLEENA IUD
|
COPPER IUD
|
IMPLANON
|
|---|---|---|---|---|
|
WHAT IS IT?
|
Depo-Provera is a long-acting contraceptive containing medroxyprogesterone acetate.
|
Is a small “T” shaped plastic device containing a progestogen Mirena has 52 mg and Kyleena 19.5 of progesterone (LNG)
|
Is a small plastic and copper device that is inserted into the uterus by a trained doctor. Copper IUD – there is a 5 year and 10 year copper IUD available.
|
This is a small matchstick sized device containing progestogen that is inserted into the skin of the upper arm.
|
|
HOW LONG WILL IT LAST?
|
Each injection lasts for three months. It must be given into the gluteal muscle by your local doctor.
|
Mirena lasts for 7years Kylena last for 5 years. Either can be removed earlier.
|
Can stay in the uterus for 5 years then needs to be replaced. Can be removed earlier
|
Needs to be replaced every 3 years but can be removed earlier.
|
|
HOW DOES IT WORK?
|
It helps prevent ovulation, thickens cervical mucus and thins the lining of the uterus to prevent implantation.
|
It will change the lining of the uterus, making implantation difficult and also increase cervical mucus, preventing sperm from entering the uterus
|
The copper in the IUD causes a chemical reaction in the lining of the uterus to make it not suitable for fertilization and implantation.
|
The implant continuously releases a small amount of progestogen to prevent ovulation, and increase cervical mucus.
|
|
EFFECTIVENESS?
|
When taken correctly failure rates are as low as 0.5 % (one in 200).
|
Less than one in 1000 women will fall pregnant. Kyleena one in 500 Efficacy: Mirena is 1/1000 Kyleena is 1/500
|
One in 100 women will fall pregnant each year
|
Less than one in 1000 women will fall pregnant.
|
|
ADVANTAGES
|
Highly effective. Easy- no pills to remember. Nothing interferes with it working. Inexpensive. Safer for women unable to take estrogen (e.g. smokers)
|
Very effective for women with very heavy periods as designed to lighten bleeding. Nothing interferes with it working. Safe option for women unable to take estrogen. Can be used during breast- feeding.
|
Provides an effective option for women unable to take any hormones, provided their periods are not heavy.
|
Is a good option for women who find remembering the pill difficult and who have not had a child. Can be removed if side effects occur.
|
|
DISADVANTAGES
|
Once injected it cannot be reversed, so if you have side effects (weight gain, mood swings, headaches, irregular bleeding) you need to wait until they wear off. There can be a delay to return to fertility of up to one year
|
You need to have it inserted by a trained doctor / gynaecologist. In a woman who has not had a baby an analgesia and or sedation if requirement May cause cessation of periods.
|
You need to have it inserted by a trained doctor/gynaecologist. Not suitable for women with a history of heavy or painful periods.
|
Needs to be inserted by a trained doctor. Some women (20%) will experience weight gain. Acne and mood swings also possible.
|
|
WILL IT CHANGE MY PERIODS?
|
50 % of women will stop having periods. Some women will have unpredictable spotting / bleeding which will often settle after 3 months or your second
|
Many women will experience spotting /irregular light bleeding for first 3 months which normally settles.
|
Period bleeding can become up to 40 % heavier and period pain might increase.
|
Approximately 30 % of women will have a normal period, 30 % will not have any periods and 30 % will have irregular bleeding for first 3 months (of which half will settle down)
|
What is a Copper IUD?
A copper IUD is a small device with a fine copper wire wrapped around a plastic frame. It’s placed inside the uterus to prevent pregnancy. A fine nylon thread is attached to the IUD. The thread comes out through the cervix into the top end of the vagina. There are two types of copper IUDs available in Australia – one lasts for
5 years and the other for 10 years.
How does the copper IUD work?
The IUD is placed inside your uterus by a doctor.
The copper IUD:
• is toxic to the egg and sperm which stops sperm from fertilising the egg
• slows the transport of the egg to delay chance of sperm and egg meeting
• changes the lining of the uterus to make it unable to support a fertilised egg
How well does the Copper IUD work?
The copper IUD is 99.5% effective.
Who can use the Copper IUD?
• most women who want a reliable, long term contraceptive
• women who haven’t had a pregnancy, have completed their families, or are spacing their pregnancies
• women who are breastfeeding
• women who cannot, or do not want to, use hormonal contraception because of medical conditions preference
When you should NOT use the Copper IUD?
• you think you might be pregnant
• you have had a recent infection called pelvic inflammatory disease (PID)
• you have unusual bleeding from your vagina
• you have Wilson’s disease or you are allergic to copper
When to talk to your Doctor before having the Copper IUD
• if you have painful or heavy long lasting periods
• if you have anaemia (not enough iron in your blood)
• if you have had a recent sexually transmissible infection (STI)
• if you have fibroids or other conditions that change the shape of your uterus
• if you have had problems in the past with an IUD (for instance it has come out by itself)
• if you are unable to have a follow-up check-up after the IUD is put in Advantages
• It’s very effective • It can stay in place for 5 or 10 years depending on which one you choose
• The initial cost of a coper IUD is more than for other methods, but it lasts for 5 or 10 years so it works out to
be a reasonable price • It does not contain hormones so it has no hormonal side-effects
• Your fertility goes back to normal straight away when you take it out
• It can be used as emergency contraception if it is put in up to 5 days after unprotected sex
Disadvantages
• It doesn’t protect against sexually transmissible infections (STIs)
• It requires a procedure to be put in and removed from the uterus; putting it in can be uncomfortable
• When the IUD is put in there is a small chance of: –
- difficulty inserting the IUD damage to the wall of the
- uterus infection
- It can sometimes come out by itself
- Your periods can be heavier and last longer
- You can have some irregular spot bleeding in the first few months
How do I get a Copper IUD?
Only a specially trained doctor or nurse can put in an IUD. You may need to make two visits.
- the doctor and/or nurse will ask questions about your health
- you might have a vaginal examination, a cervical screening test or a test for infection
- putting the IUD in takes about 10 minutes
- you may find it uncomfortable or painful and some women feel faint
- you can have a local anaesthetic. Some women have the IUD inserted under sedation. We are able offer pain relief to make your experience more comfortable.
After your Copper IUD is put in
- you may have cramps and bleeding or spotting in the first few days
- avoid sex, tampons, swimming and baths for 2 days to reduce the risk of infection
- go back for a check-up 4 to 6 weeks after the IUD is put in
- check the IUD threads each month after your period to make sure the IUD is still in the right place Things to remember with your Copper IUD
- check the threads each month after your period to make sure the IUD is still in the right place if you have any unusual symptoms (discharge from your vagina, pain low in your tummy or deep pain during sex) see your doctor straight away
- if you are worried you could be pregnant, have a pregnancy test
- if you or your partner have a new sexual partner, use a condom every time until you both have been checked for STIs
- keep a record of the date to take out your IUD – it shouldn’t stay in for longer than the recommended time
Implanon
What Is It?
Implanon is a contraceptive implant device inserted under the skin of the inner upper arm. It is a soft rod which is 4cm long and 2mm wide in diameter. Once inserted it can be felt, but not easily seen.
It contains only the hormone progestogen, similar to the progesterone that occurs naturally in the body.
How Does It Work?
The main action of lmplanon is to prevent ovulation (the production and release of an unfertilised egg). It also works by thickening the mucus produced by the cervix (entrance from the vagina to the uterus), which prevents sperm from getting through into the uterus.
How and When is it Inserted?
lmplanon is inserted by Dr Kenney who has been specially trained. The insertion takes only a few minutes and is performed with local anaesthetic to minimise pain. After the local anaesthetic wears off (a few hours), there is usually some soreness and noticeable bruising, which settles within a few days. If it is inserted during the first 5 days of a period, the contraceptive implant is effective immediately. If inserted at other times of the menstrual cycle, it will be effective after 7 days. You must check with your doctor that you are not pregnant at the time of insertion.
Who Is lmplanon Suitable For?
lmplanon may be appropriate if:
- You want effective contraception, particularly if you have difficulty remembering to take pills every day.
- You have difficulties with other forms of contraception.
- Implanon is safe and used for people who have previously had blood clots
- You are unable to take contraception which contains oestrogen.
- Implanon is suitable post partum ad can be inserted straight after childbirth
Who Is lmplanon NOT Suitable For?
Generally, lmplanon is thought to be safe for most women. However, care should be taken if:
- You are breastfeeding. Although it has been studied in only a small number of mothers and their babies, lmplanon is probably safe.-remove this.
- You have a history heart disease, liver disease or take medications for epilepsy. You may still be able to use lmplanon but you need to have a detailed discussion with your doctor.
- You have had breast cancer.
What Are The Advantages?
- The hormone is released slowly and continuously into the blood stream from the implant, therefore there is no need to remember to take a pill every day. The body also produces its own natural oestrogen at normal levels.
- This means there is unlikely to be any increased risk of osteoporosis (thinning of the bones) when on lmplanon. Research is still being conducted but all the results appear to be
encouraging. - Women who suffer from premenstrual tension (PMT) may experience a reduction of symptoms and bleeding may be less painful. Generally, women have fewer bleeding days and less total bleeding, than they would with their usual periods. On removal of the implant, any side effects or contraceptive effect are quickly reversed.
What Are The Disadvantages?
The main disadvantage is irregular bleeding pattern. This is because lmplanon contains progestogen only and it is the oestrogen in ‘the (combined) pill&’ that helps to regulate bleeding.
20% of women using lmplanon will have no bleeding.
However, a small percentage of women may have a small amount of bleeding every day. Other bleeding patterns exist between these two extremes and all patterns may settle in the first 3 to 4 months. However, they are unlikely to settle if they continue after this.
About 20% of women have bleeding patterns that are unacceptable to them, and consequently choose to have the implant removed. Your doctor may advise you to leave lmplanon in for three or more months, to see if bleeding does settle and may commence you on the pill at the same time as this has been successful in stopping bleeding for some women.
Some women are quite sensitive to the hormone in lmplanon and may gain weight; some women may lose weight.
Other possible side effects are acne, breast tenderness, a lower sex drive and headaches. Importantly, lmplanon does not protect from sexually transmissible infections (STls). Condoms and dams (for safer oral sex) need to be used, as a protection against STls. Ask your doctor when you need a check for STls.
There is a very minor chance that the Implanon can move from the site of insertion and require surgical removal.
How Long Does It Last and How Effective is it?
Each lmplanon rod is effective for three years. After three years, the rod needs to be removed and replaced. Removal and insertion may be done on the same day.
When correctly inserted by a doctor trained in this procedure, lmplanon is over 99.9% effective.
World-wide, few women using lmplanon have become pregnant.
What If I Don’t Like It or Want to Fall Pregnant?
lmplanon can be removed at any stage.
Unless symptoms are severe, women are encouraged to keep lmplanon in for at least three months, as there is a good chance any side effects will settle after this.
After removal, any side effects should be reversed within weeks and most women begin to ovulate (produce eggs) soon after the removal.
Women who stop using lmplanon are therefore expected to have the same chance of falling pregnant, as women who stop using other forms of contraception.
Fertility is thought to be unaffected long term.
How Is It Removed?
The Doctor will inject local anaesthetic over the implant. A small cut is made in the skin and the lmplanon rod is removed through this. There will be a small scar but no stitches are required.
It usually takes 10 to 15 minutes and is fairly straight forward for a doctor trained in lmplanon procedures.
If the lmplanon rod is deeper than usual, which is uncommon, the procedure may take longer as it will need to be removed with ultrasound guidance. This will be done in a hospital with a specialist in this field. The doctor will discuss this with you before the procedure goes ahead.
Chlamydia
Chlamydia is one of the most common sexually transmitted infections. It is thought that up to one in ten sexually active young people have Chlamydia. If left untreated it can cause pelvic inflammatory disease, increase the risk of an ectopic pregnancy and infertility. If you are diagnosed with Chlamydia at the time of a surgical abortion then this can increase your chances of developing a pelvic infection after the surgery. It is vital that you take the antibiotics prescribed by the doctor to prevent this from occurring and to clear it from your body.
Chlamydia trachomatis is a bacteria, passed from one person to another through sexual contact (unprotected vaginal, anal or oral sex) or sharing sex toys if you don’t wash them or cover them with a new condom each time they are used. Chlamydia lives in the cells of the cervix, the urethra (the tube where urine comes out), the rectum and sometimes the throat and eye. Infected semen or vaginal fluid coming into contact with the eyes can cause conjunctivitis. Chlamydia can also be passed from pregnant women to her baby.
You cannot catch Chlamydia from kissing, hugging, sharing baths or towels, swimming pools or toilet seats. Many people infected with Chlamydia will have not have any obvious symptoms or be so mild they might go unnoticed. (70% of infected women do not have symptoms and 50% of infected men.) Symptoms in women include: pain when passing urine, an unusual vaginal discharge, lower abdominal pain, pain or bleeding when you have sex, bleeding after sex, irregular bleeding between periods. Symptoms in men include: a white/cloudy discharge from the penis, pain when passing urine, possible pain in the testicles. As many people do not have symptoms it is often extremely difficult to know how long the Chlamydia has been present if prior testing has not been performed.
If you have been diagnosed with Chlamydia it is very important that you discuss this with your sexual partner and any other possible past contacts. We encourage your partner to see their local doctor to discuss treatment. You must both be treated otherwise there is a high chance that the untreated person will re-infect the treated person. It is essential that condoms are worn until the follow up tests demonstrate that you both have a negative result.
Follow up testing is now only required in specific circumstances not for everyone and the current guidelines have gone back to doxycycline 10o mg bd for 10 days not azithromycin any more. The treatment is very effective (about 98% effective) and usually involves a single dose of two antibiotic tablets for yourself and your partner. Please notify the doctor if you are allergic to Erythromycin or Azithromycin. Please tell the doctor if you are breastfeeding or pregnant.
Chlamydia testing is very sensitive however it is possible to have the infection even when your test is negative so most doctors will treat the sexual partner of a diagnosed with Chlamydia. Once Chlamydia is diagnosed it is often important to perform further tests to assess for other sexually transmitted diseases.
We advise speaking to your local doctor or booking a general appointment to discuss this.
If you are experiencing difficulty discussing this with your partner you may access the Let them Know website where you can send an anonymous and discreet text or email www.letthemknow.org.au Note: This website is closely monitored for misuse.
Complaints
It is our aim to ensure all personnel at Une Femme work with you in a professional and caring manner.
Should you have an issue with the care provided please let us know.
A complaint can be lodged in writing, by telephone or in person. Anyone can make a complaint such as a patient family or friend.
Who is the Complaints Manager
All Complaints are dealt with via the Practice Manager. It is important that this is dealt with and your views are heard and acknowledged.
It is the Practice Manager’s role to follow up with any individual who has complained to see if they were happy with the way their complaint was handled. IF the individual with the complaint remains dissatisfied, they are advised to utilise external services such as the Health Services Commissioner.
