• implants
• long-acting reversible contraception
• counselling
• education and training
• family planning service provision

The subdermal implant is an efficacious, cost-effective method of long-acting reversible contraception with an excellent safety profile,1 favourably evaluated by the National Institute for Health and Care Excellence.2 Yet, amongst health care professionals and patients alike there remain obstacles to its uptake. There is often a degree of reticence or reluctance in both promotion and uptake based on perceptions of high removal rates or poor tolerance, especially to nuisance bleeding.3 ,4

I performed a review to investigate the seemingly high removal rate within our community sexual and reproductive health service in Yorkshire, UK. Our service serves a population with a broad demographic across both urban and semi-rural areas, with 28 000 contacts annually.

I reviewed the notes of all patients who attended for Nexplanon^® removal between 1 October and 31 December …