We are excited and grateful to welcome Dr Marj Quinlan to our team. Marj has many years experience inserting coils and implants and training other doctors to learn these skills.

To date we have only been able to offer removal of coils and implants but now we can extend this to the removal and replacement of both.

Marj is also skilled in removing coils that have migrated further into the womb where the strings are no longer visible.

Below we describe the implant insertion and removal and also the coil insertion process

HOW IS A contraceptive IMPLANT INSERTED?

A contraceptive implant is a small, flexible rod ( see the picture below) that is inserted under the skin of a woman's upper arm to provide long-term birth control. Here's a general overview of how a contraceptive implant is inserted by a doctor:

1. Consultation: Before getting the implant, you will have a consultation with the doctor, usually by phone or video consultation. During this appointment, you can discuss your birth control options, potential side effects, and any concerns you may have. Your healthcare provider will confirm that the implant is a suitable choice for you.

2. Scheduling the insertion: If you and your doctor decide that the implant is the right choice, you'll schedule an appointment for the insertion procedure. It's essential to ensure that you're not pregnant at the time of insertion.

3. Pre-insertion preparations: On the day of the insertion, the doctor will first review your medical history and perform a physical examination. They will also discuss the procedure with you once again and answer any last-minute questions.

4. Anaesthesia: Local anaesthesia is typically used to numb the area on your upper arm where the implant will be inserted. This numbing agent helps reduce any pain or discomfort during the procedure.

5. Sterilisation and marking: The the doctor will sterilise the area around your upper arm and make a small mark to indicate the exact spot where the implant will be inserted.

6. Insertion: Using a specialised applicator, the doctor will insert the implant just beneath the skin of your upper arm. The implant is typically placed on the inside of your non-dominant arm, about 3-4 inches above the elbow crease. The entire procedure usually takes only a few minutes.

7. Dressing and bandage: After the implant is inserted, a small bandage or dressing may be applied to the insertion site to keep it clean and protected as it heals.

8. Post-insertion instructions: the doctor will provide you with specific instructions on how to care for the insertion site, what to expect in the days and weeks following the procedure, and when to schedule a follow-up visit.

9. Activation and effectiveness: The contraceptive implant may start working immediately if inserted during certain parts of your menstrual cycle. However, it's essential to use backup contraception for the first week after insertion to ensure its effectiveness.

The contraceptive implant is designed to provide contraception for up to three years, after which it can be removed or replaced if you wish to continue using it or choose another method of birth control.

If you experience any side effects or concerns, such as infection or migration of the implant, consult the doctor promptly.

HOW IS AN IMPLANT REMOVED?

Most implants are placed under the upper arm where there is usually some fatty tissue.

The doctor will examine your arm and feel for the implant. She will then push the contraceptive implant towards the surface of the skin and mark the skin with an X where the end of the implant is visible. This mark may be in a different area than the scar you have from insertion of your implant.

The skin will be cleaned with iodine solution to ensure it is sterile. Next a small area is injected with freezing liquid to ensure the procedure is not painful.

After five minutes the doctor will test that your skin is numb and if so, she will make a small cut in the skin approximately half cm wide with a sharp scalpel. The doctor will then push the contraceptive implant up towards the skin until it’s tip is seen. Then the doctor will prize the implant gently away from the attached tissue until it pops out.

Once the implant is removed the skin is then closed over with some paper strips and a dressing. If a larger cut is needed to locate the implant suture /stitches may be needed to close the skin cleanly.

Contraceptive coil insertion

There are two main hormone coils and two types non hormonal coils made of copper. These are also known as an intrauterine device (IUD), which is a small T-shaped device that is inserted into a woman's uterus by a healthcare provider. YOu must see the doctor either in erpson or by video to discuss which coil is most suitable for you.

The copper coil can make periods heavier for some women but does not have any hormonal side-effects. The hormonal coils are generally well tolerated but for a some women they do experience the side effects of the progesterone type hormone.

The procedure is typically done in a doctor's office or a clinic and involves the following steps

1. Preparing for the Procedure:

   • Before the insertion, you will have a discussion with your healthcare provider about your medical history, any allergies, and any questions or concerns you may have.

   • Your healthcare provider will perform a pelvic exam to assess the size and position of your uterus.

   • YOu will then have the full procedure aexplained and a consent form will be completed

   • YOu can then book in for the procedure, this is usually on a Monday

   • We recommend that you take a pain medication sucha as 1gram paracetamol or ibuprofen 400mg two hours before the main procedure.

2. Prodecure:

   • You will be asked to lie down on an examination table with your legs up, similar to a pelvic exam.

   • YOu can bring someone with you, and our health care assistant Tina Fegan will also be present to assist and chat to you for distraction.

   • We like to play some music to creat a relaxed atmosphere.

3. Cleaning and Sterilizing:

   • The doctor will clean the cervix and the surrounding area with an antiseptic solution to reduce the risk of infection.

4. Numbing:

   • In some cases, a local anesthetic may be applied to the cervix to minimize discomfort during the procedure.

5. Insertion:

   • The Mirena coil is inserted through the cervix and into the uterus using a thin, flexible tube called an inserter.

   • The doctor will measure the depth of the uterus to ensure proper placement of the IUD.

   • Once the IUD is in the correct position in the uterus, the doctor releases it from the inserter, allowing the arms of the T-shaped device to expand and anchor it in place.

6. Trimming:

   • The healthcare provider may trim the threads attached to the IUD, leaving a small length of thread visible at the cervix. These threads are used for checking the position of the IUD and for removal in the future.

7. Recovery:

   • You may experience mild cramping, spotting, or discomfort after the procedure. These symptoms usually subside within a few hours to a few days.

It's important to note that the hormonal coils are long-acting contraceptive that can provide birth control for up to five years depending on which is chosen.

It works by releasing a low dose of the hormone levonorgestrel, which thickens cervical mucus to prevent sperm entering the womb and it makes the uterine lining less receptive to implantation , thereby preventing pregnancy.

The Hormone coils are also useful for heavy periods and in particular for women beginning to approach menopause.

It can we used to protect the womb when taking the Oestrogen form of HRT only in both the perimenopause and menopause and reduces your risk of womb cancer also.

If you have any concerns or experience unusual symptoms after the insertion, it's essential to contact one of our doctors for guidance and follow-up care. Additionally, regular check-ups with your healthcare provider are important to ensure the IUD remains in the correct position and is providing effective contraception.