Issues with the birth control implant
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DEAR DR MITCHELL,

I have the Jadelle and I’m experiencing many issues, like mood swings, heavy bleeding, weight gain, and depression. I want it removed, but the clinic says I have to keep it for a few more months. What could be happening, and would you suggest that I try to remove it privately? I have heard all kinds of horror stories about this implant, and I just want to be safe and healthy.

The Jadelle is an implant that is inserted under the skin to prevent pregnancy. It contains levonorgestrel, which is a progesterone preparation. It does not contain any oestrogen and so is an extremely safe method of contraception for women who have high blood pressure, heart disease, or oestrogen sensitive tumours such as breast cancer.

It can present with mood swings, irregular bleeding, weight gain, and depression in some women. If the set-up for mood swings and depression is already present then the progesterone in the implant can cause this to increase in some cases.

The irregular bleeding with the insertion of Jadelle is usually mild and tends to settle down within one year of the insertion of the implant. If you are experiencing heavy bleeding you should consult your doctor and get a proper evaluation, including a pelvic ultrasound and a Pap smear to rule out problems in the uterus, ovaries, and cervix.

The heavy bleeding can sometimes be controlled by taking a low-dose oral contraceptive pill for a few months until the hormone in the Jadelle controls the bleeding. This will help to reduce the need for removing the implant prematurely. The mood swings and depression should also be evaluated to determine if there are other factors in your relationship or family that is triggering these feelings. The mood swings usually settle down if it is hormone-related.

The Jadelle can be left in place with effective contraceptive benefit for five years, so you should allow some time to see if the symptoms settle. You should get involved in a regular exercises programme at least three times per week and go on a low-calorie diet with reduced fried foods and sugar. This will help to decrease your weight gain and lift your spirits.

The Jadelle implant can be removed by a private doctor if you have tried all the measures and the symptoms are still present. The use of the intrauterine contraceptive device called Copper T would be a good alternative since it does not have any hormones. This method is effective and does not affect your weight or mood in any way. The Jadelle could be removed and the Copper T inserted at the same visit.

Consult your gynaecologist or health centre for further information.

Best regards.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Avenue, Kingston 5 or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.

DISCLAIMER:

The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.

Dr Sharmaine MITCHELL

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