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Choosing the right contraceptive option allows you to be in control of when you choose to conceive.

There are a number of different contraceptive options available and it may be useful to look at advice from NHS Choices (www.nhs.uk/conditions/contraception).

In the end the choice you make will be a personal one and Mr Miskry can give advice about the different options. The commonest are outlined below:

 

REVERSIBLE CONTRACEPTION

Barrier methods

Most people will be familiar with condoms but there are also other barrier methods including caps or diaphragms and the female condom. Barrier methods provide some protection again sexually transmitted infections (STI) including serious conditions such as hepatitis and HIV. The biggest disadvantage for most people is that they need to be used at the time of intercourse and if used incorrectly have a higher failure rate than other methods of contraception.

Oral contraceptive pills

‘The pill’ is one of the most common forms of contraception used in the UK and is highly effective. It can also make periods lighter and less painful and in some cases help with premenstrual symptoms. As it is a hormonal form of contraception there can be side-effects and there are some risks. The pill is only effective if taken properly and long-term fertility is unaffected.

 

There are two forms of oral contraceptive:

The combined oral contraceptive pill (COCP): This contains estrogen and progestogen and works by stopping ovulation. It is particularly good at making periods less heavy and painful but is associated with an increased risk of blood clot (thrombosis) eg DVT or pulmonary embolus which are serious complications. Some types of pill have greater risk than others. The pill is not suitable for all women and in particular is not appropriate for heavy smokers or women with a personal history or family history of blood clotting or a personal history of migraine. There appears to be a small increase in risk of breast and cervical cancer in women who take the COCP long-term but also a significant reduction in the lifetime risk of ovarian cancer. Generally the COCP is well tolerated but it is not uncommon to get breast tenderness, headache or nausea in the first three months.

The progestogen only pill (POP): The POP works by thickening cervical mucus to prevent sperm getting through the barrier at the cervix. It does need to be taken at the same time every day (usually within a two hour window, but this depends on which POP you are prescribed). The commonest side-effect with the POP is irregular (breakthrough bleeding) but it can also be associated with mood change and acne.

Intra-uterine devices

This increases the contraceptive efficacy (the Mirena is the most effective form of reversible contraception available) and can also reduce menstrual blood loss and pelvic pain. The Mirena is often used in women with endometriosis or heavy, painful periods due to its suppressive effects on the menstrual cycle. The biggest problem with hormone releasing coils is that they are often associated with very unpredictable bleeding – particularly in the first 3 months of use, and that up to 1 in 6 women will ask for it to be removed. This is usually because of ongoing unpredictable bleeding or side-effects that can include mood change, bloating or acne.There are two kinds of IUD: hormonal and non-hormonal. The copper coil is non-hormonal and works by causing an inflammatory reaction (which is unfavourable for implantation of a pregnancy) in the cavity of the womb as well as the copper being relatively toxic to sperm.

Intra-uterine devices

Copper coils often make periods a little more painful and can be associated with increased vaginal discharge. The hormone releasing coils include the Mirena which releases a small dose of local progestogen hormone. This increases the contraceptive efficacy (the Mirena is the most effective form of reversible contraception available) and can also reduce menstrual blood loss and pelvic pain. The Mirena is often used in women with endometriosis or heavy, painful periods due to its suppressive effects on the menstrual cycle. The biggest problem with hormone releasing coils is that they are often associated with very unpredicatable bleeding – particularly in the first 3 months of use, and that up to 1 in 6 women will ask for it to be removed. This is usually because of ongoing unpredictable bleeding or side-effects that can include mood change, bloating or acne.

 

Fitting an IUD

Fitting a coil is usually relatively straightforward and is done in the clinic. It involves being examined (a bit like a smear test) to assess the shape, size and position of the womb and cervix (neck of the womb). The coil itself is pushed up through the cervix into the cavity of the womb. There are two strings attached to the device which are then trimmed so that they remain close to the cervix. These strings are there to allow easy removal of the device. Most IUD’s are licensed for contraception for 5 years.

Mr Miskry recommends taking some simple over the counter painkillers (eg paracetamol or ibuprofen) and hour or so before having a coil fitted and remember to bring a pad or panty liner as there may be some bleeding afterwards. It is also sensible to have something to eat and drink before the appointment and not plan to go back to work immediately afterwards in case you get some discomfort (period type cramps). The whole process of examination and fitting typically take less than 5 minutes and is usually tolerated very well.

The main risks of using a coil are either introducing infection (in particular chlamydia if it present in the cervix) or much less commonly perforation of the womb (where the instrument or coil is passed through the entire thickness of the muscle of the womb).

Request an appointment

Clinics are three times a week and Gail will help you arrange a time to see Mr Miskry and if necessary a scan on the same day.

If you are pregnant, you can expect to have a number of routine tests and appointments and you can find out more about the schedule of care here.

Appointments can be arranged by phone or email.

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What our patients say about us

thank you so much for the fantastic care both before, during and after Alice’s birth…we felt in extremely safe and capable hands at the time of her delivery, which was a huge relief. Many, many thanks for your skill and dedication

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we will always appreciate the great care and support you have given us through all our pregnancies

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FAQs

These are some of our most commonly asked questions, but you can see all of them here

Do I need a GP referral for private treatment?

No. However if you have private medical insurance please check with your insurer as they may require a GP referral in order to provide cover.

Where does Mr Miskry see patients?

All clinics are held at 148 Harley Street.

Where does Mr Miskry perform operations?

The Lindo Wing, St Mary’s Hospital and The Wellington Hospital.

If I have a private consultation will this alter my care in the NHS?

No. Your treatment or position on an NHS waiting list will not be affected by having had a private consultation/surgery.

Are tests included in my consultation fee?

Any tests Mr Miskry recommends as part of your care are payable directly to the clinic/lab/hospital where they are carried out and are not part of our fees.