In this episode of The Good GP, host Dr Sean Stevens along with Dr Rebecca Goadby interview Dr Alison Creagh, renowned for her expertise in intimate partner violence and contraceptive management. Alison addresses managing the side effects of long-acting reversible contraceptives (LARCs), focusing on contraceptive implants and intrauterine devices (IUDs).

Alison discusses the common issue of unpredictable bleeding with contraceptive implants, providing detailed insights into identifying potential causes, assessing the pattern of bleeding, and discussing management options with patients. She highlights the significance of ruling out abnormal causes and offers a range of strategies, including reassurance, combined pill usage, anti-inflammatory and hormonal options, and considering alternative contraceptives, if necessary. Additionally, she provides guidance on addressing weight gain, headaches, loss of libido, and concerns around fertility associated with long-acting contraceptives, dispelling myths and offering practical advice to reassure patients.

Their discussion then delves into challenges related to IUD insertions, addressing potential pain, bleeding, and cramping post-insertion. Alison outlines strategies for pain management during insertion, discusses the normality of bleeding patterns post-insertion, and shares management options for heavier bleeding or cramping.

The conversation concludes with Alison demystifying fertility concerns associated with LARCs, providing clarity on the rapid return to normal fertility post-discontinuation of contraceptive methods.

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