48 e-Letters

published between 2011 and 2014

  • Experience and removal of damaged implants
    Janet Bentley

    Dr Elliman[1] asked whether other clinicians had experience of damaged implants. Rekers[2] replied that breakage is rare and would not alter contraceptive efficacy.

    I have removed damaged implants from seven patients since June 2011, all of which were sited correctly. Two patients underwent subsequent removal of a second damaged implant. All the patients were aware of abnormality, but only one remembered trauma...

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  • Comment on 'An emergency contraception algorithm based on risk assessment: changes in clinicians' practice and patients' choices': authors' response
    Rebecca J McKay

    We thank Drs Cogswell and Lipetz[1] for their comments on our article[2] and for sharing the interesting results of their audits. They have clearly demonstrated the importance of staff training in increasing uptake of the emergency intrauterine device (IUD). Further work within our service supports their conclusion.

    In response to the apparent fall in IUD uptake when ulipristil acetate (UPA) was introduced, the...

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  • Involving young people in service design
    Sharmila Parks

    I read with interest the article Garrett and Kirkman et al.[1] wrote on the limited success of the pilot telemedicine sexual health service and their reflections on needing more advice from what young people thought to have got it right.

    A 2008 UNICEF statement entitled 'Young People: Partners for Health'[2] written by an international group of young people states: "Young people need to be at the forefront in the...

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  • Comment on 'An emergency contraception algorithm based on risk assessment: changes in clinicians' practice and patients' choices'
    Charlotte Cogswell

    As with McKay and Gilbert[1] in Cambridge, UK, we also developed an emergency contraception (EC) algorithm following the introduction of ulipristal acetate (UPA), likewise recognising that fitting an intrauterine device (IUD) was the 'gold standard'. Our ongoing experience is rather different, however, in that our rates of emergency IUD fitting have increased since the introduction of our algorithm from 6% to at least 9%...

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  • Unusual shaped IUS
    Alwyn R N Lloyd

    I read with interest Anne MacGregor's letter in the January 2013 issue of the Journal describing the removal of an unusually shaped intrauterine system (IUS) and asking if others have had similar experiences.[1]

    A couple of years ago I too was alarmed as I removed an IUS through a slightly tight cervical os and noted an odd shape. On closer inspection the device was removed intact but as in Dr MacGregor's case t...

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  • Comment on 'Impact of UK Medical Eligibility Criteria implementation on prescribing of combined hormonal contraceptives': author's response
    Paula Briggs

    On behalf of all the authors I would like to thank Sarah Holden for her comments[1] on our recently published article.[2]

    When designing the study, we recognised that the majority of women receive their contraception from their general practitioner (GP). Our study compares the prescribing habits of GPs in 2005 pre-UK Medical Eligibility Criteria (pre-UKMEC) to those in 2010 (post-UKMEC).

    Whilst the aut...

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  • Early implant removal
    Jane M Wilson

    I read the letter on 'Early implant removal: an ethical dilemma' by Bari et al.[1] in the January 2013 issue of the Journal with interest, a great feeling of disappointment and I shared the feelings of alarm with the authors. The piece reported a 29-year-old woman who was so dissatisfied with her subdermal implant that she attempted removal herself without anaesthetic and she broke the device. She had requested removal f...

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  • Comment on 'Impact of UK Medical Eligibility Criteria implementation on prescribing of combined hormonal contraceptives'
    Sarah E Holden

    I read the article by Briggs and colleagues[1] with interest as it is, to my knowledge, the only study to assess the impact of the implementation of the UK Medical Eligibility Criteria on general practice prescribing of combined hormonal contraceptives (CHCs) in the UK. However, I have a study limitation.

    As the authors have stated, oral contraception can be accessed on prescription from a general practitioner (...

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  • Response to an unusual shaped IUS
    Adam Forrest

    I read with interest Dr MacGregor's letter[1] regarding the unusual shape of a Mirena intrauterine system (IUS) following removal. From the photograph it would appear that the capsule has become displaced and the arms of the device enclosed within it.

    We have seen a case of complete detachment of the capsule from the frame, with unrecognised retention of the capsule within the uterine cavity. This was only reco...

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  • Learning from Romanian women's struggle to manage their fertility
    Ann Furedi

    The commentary by Horga et al.[1] on the consequences of Ceausescu's attempt to ban abortion in Romania is a stark reminder of what happens when women are prevented from accessing safe and legal means to end problem pregnancies. In short, they end their pregnancies using means that are unlawful and/or unsafe, sometimes with tragic consequences.

    Although it is difficult to compare any country today with the repre...

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