Dr Thomas Stuttaford
2 for 1 tickets to Casablanca, this coming Monday

Dr Thomas Stuttaford's next online forum (live on February 13, after 1pm) is: Contraception. To ask the doctor your question on this topic and to read other recent topics he has answered click here
![]()
A 28-year-old unmarried reader has asked whether she should heed the advice of the public health minister and change from the combined pill as a contraceptive to an injection every three months from her GP.
The minister’s advice to GPs to consider every type of contraceptive available would be accepted by most doctors. However each method must be chosen to provide the best option for the patient rather than as a cost-saving exercise.
The pill has fewer side-effects than other forms of contraception, but it may also react with other drugs that can affect its action. The side-effects of the combined pill are usually acceptable provided that it is not taken by women older than the mid-thirties.
Unfortunately 88 per cent of women forget to take the pill regularly, according to research. In other cases its absorption may be compromised by vomiting or diarrhoea. This latter problem is especially important in older women taking the progestogen-only mini pill.
The advantage of the three-monthly injection Depo-Provira medroxyprogestrone is that the patient can be certain that she has taken it and, provided she keeps her appointments, will be covered regardless of a lapse of memory, illness or an impulsive desire to become pregnant.
The disadvantages of Depo-Provira are not always acceptable to patients. Some suffer from one or more of a variety side-effects that include weight gain, acne, facial hair, mood changes including depression and irritable aggression, headaches, visual disturbances and migraine.
From my own experience, patients taking Depo-Provira are most likely to be upset by irregular vaginal bleeding. This is especially likely to cause problems in the first few months.
I always found that Mirena, a T-shaped intrauterine system that lasts five years, is very acceptable to women but it is usually only recommended for older patients in long-term relationships. The use of an implant is usually considered to involve too much fuss.
Enjoy screenings of all the classic films you love.
Have you ever dreamed of owning your own racehorse or a beautiful painting?
Enjoy comfort, safety, space and great design. Plus enter our great competition
Are you California dreaming? Explore the wonders of the Golden State. Also enter our fantastic competition
Do you have what it takes to be a Times photographer?
Your brain is capable of more than you might think...
Find out to make the most of your money with our wealth management guides
Need help with your property? We have an entire how to guide - buying, selling, letting, moving, to help you
Everything the Business Traveller needs to know to make a better trip
We are seeking entries for the inaugural Sunday Times Best Green Companies Awards
Enjoy some wonderful inspiring wildlife moments
An interactive preview of the brand new For Your Eyes Only exhibition

Love Sudoku? Play our brand new interactive game: with added functionality and daily prizes

Are you irritable when you return from work? Drained of emotion? You could be suffering from boreout
Prepare for some shock and awe, petrol lovers. Despite the greens trying to wipe it out, the car is about to offer us the most exciting year ever
We've trawled the brochures and websites to find this summer’s best holidays for every taste and budget

Luxurious spa gift set, ethical and eco-friendly

Everything you need to know, own or do

50% off top restaurants, book now

2007/07
£57,500
South East England
2007/57
£22,950
The Midlands
2006/06
£41,995
South East England
Great car insurance deals online
£40-55k+benefits+uncapped commission
Morgan Keating
South East
£60k plus excellent benefits
Barclaycard
Stockton / Northampton
£
£55,000 - £75,000 plus bonus and benefits
Diligenta
Based in Peterborough
£45,000 - £70,000 plus bonus and benefits
Diligenta
Based in Peterborough
Globrix, the property search engine
Visit Times Online Property for homes for sale or rent
Residential development site with planning permission
£1,500,000
Mortgages, bank accounts & money transfers to help you buy abroad
Dinarobin Hotel Golf & Spa 7 nights
From £1830 per person – saving £530.
Smart prices on ATOL protected holidays
Excellent online info & holiday selection.
Walt Disney World Resort Florida SALE!
From £619 per person!
Great travel insurance deals online
Contact our advertising team for advertising and sponsorship in Times Online, The Times and The Sunday Times. Search globrix.com to buy or rent UK property.
© Copyright 2008 Times Newspapers Ltd.
This service is provided on Times Newspapers' standard Terms and Conditions. Please read our Privacy Policy.To inquire about a licence to reproduce material from Times Online, The Times or The Sunday Times, click here.This website is published by a member of the News International Group. News International Limited, 1 Virginia St, London E98 1XY, is the holding company for the News International group and is registered in England No 81701. VAT number GB 243 8054 69.
I also had terrible problems/ side effects from the mirena which have gone away since I had it removed. I would personally advise people to think carefully before having it inserted and do some research regarding side effects. http://www.medications.com/se/mirena
I now have the problem that at 35 my husband and I are back using condoms which is not really great. We have 2 children and don't want any more but there is not another form of contraception out there that does not put hormones into my body. I asked my dr about the diaphram/ and she laughed and said you can't get them any more.
sallyfish, leeds,
Like Kay in London, I'm also a Mirena fan. When I first became sexually active, I went to get "the pill". The doctor asked the bare minimum of questions before handing over the bog-standard contraceptive pill. I was on it for a year, during which time I ballooned in weight, became very emotional, depressed and still had quite heavy periods.
After doing a bit of research, I decided to change contraceptive and looked around for a family planning clinic. When I got there, I got a REAL consultation. A wonderful lady doctor took me through all the options (it was then that I discovered there were many types of pill) but I opted for the Mirena. Yes, it was a little painful when it was installed and I did have some bleeding and cramping but this only lasted a couple of hours. A nice hot bath and a relaxing night later, I was fine.
Some family planning clinics say it's only for women who've had children (because it's easier to install) but, if you fell it's right for you, insist!
Michelle, Glasgow,
I've been on Mirena for a bit over 2 years (I was nearly 24) and will not be getting off it. It has helped tremendously with my periods and I haven't suffered too many side effects. I took a day off work to have it inserted by the doctor (I insisted on being knocked out for it), cramped and felt ill that day, cramped a bit the following day, and then all was fine. Every couple of months I know it's 'period time', or would be, as I feel a bit moody and cramp, and then I still spot and bleed lightly for two days, but that's it. I can deal with that much better than weeks at a time bleeding heavily and feeling sick. The fact that it is the most effective contraception on the market is a huge bonus as my husband and I don't have to worry about children - the failure rate is so low that I don't even think about it. I'm definitely planning on swapping it over for a new one when the 5 year time frame is up.
Kay, London,
I know of countless women who have had fertility problems after using depo-provera. Personally I'd say don't risk it, if you want to stop your periods go for a coil.
K. smith, derbyshire, uk
I took depo-provera injection once and it was enough to stop my periods completely for more than one and a half years. It was the beginning of all sorts of problems than led to me being diagnosed with PCOS (poly cycstic ovaries). I'm not saying if I hadn't had the injection, I wouldn't have ended up with ovary problems. But all I can say is that it was the start of a worryingly irregular cycle and I regret ever having it.
Sarah, London,
Since being on Depo-Provira for 6 months, I have had bleeding (equivalent to that of a heavy period) for 4 months, have gained a stone in weight and have been generally miserable for all of that time. I would have preferred more information about the possible side-effects, rather than being fobbed off with the statement 'the next injection will sort it out'. I would not recommend this form of contraception to anyone- remembering to take a pill is a lot less complicated than explaining why you are sill bleeding after 4 months.
Laura, Durham,
I used Depo-Provera for about 9 months but had side effects that lasted for more than two years and resulted in my being referred to a specialist. From my experience I would not recommend it and think doctors and family planning clinics should give much more information about possible side effects and how long these may last before recommending it.
Tania, Surrey,
I started getting migraines after going on the combined pill. A nurse told me this was probably triggered by the oestrogen in the pill and that progestogen -only would be the better option. Unfortunately the migraines haven't completely gone away but once every month or two is a great deal more acceptable than every other day!
Victoria, Oxford,
My best friend had terrible problems with side-effects from Mirena, which made her very ill. Her doctor maintained that Mirena was not to blame, but she insisted on having it removed, and has been fine ever since. She found later that lots of women had experienced similar problems.
Alys, Colchester, UK