Interview - Dr Mukesh Haikerwal, AMA President (Victoria) - Radio 2SM - Implanon, Monday 10 February 2003

How am I going with pronunciation on your name?

HAIKERWAL: That's pretty spot on.

HENRY: So I'll call you Mukesh.

HAIKERWAL: Perfect.

HENRY: Mukesh, in regards to the contraceptive, the manufacturers apparently have been criticised a little bit about the design of this. Is it the Implanon contraceptive?

HAIKERWAL: Look, Implanon has been available in Australia for some two years and people have taken it up with a gusto because it's a really excellent method of contraception. If you look at it compared to other methods you get about seven to eight pregnancies per 10,000 when it's used properly compared to 380 per 10,000 with a pill so ...... it's an excellent method.

Now, when people use it they need to be aware that the most important thing about using this thing is that once it's in, you need to check for it. So the doctor needs to check the arm, where it's been placed under the skin in the lady, after it's been put in, and the lady also needs to be sure that it's there and just check it. If she can't feel it she should say so and it can be checked for.

So the design is actually fine but the problem is that you need to be trained to use it. It's important to have the training which was provided for most people when this was done and the only thing that, I suppose, raised a question mark was the colouring of the device inside and the tablet but basically, with proper training and knowing to feel both before insertion and - sorry, both after insertion by the doctor and by the patient - that's the safest thing to do, to know that it's actually there and if it's there it will be working.

HENRY: How long does it work for, Implanon, once it's been implanted?

HAIKERWAL: About three years so, it's excellent because the most common fault with things like the pill is people forget to take them or have some antibiotics or something at the same time and they become less effective. This way you can't forget to take it and there's no problems with anything else that you might take.

HENRY: And it just, I suppose, let's itself - how does it get into the blood flow?

HAIKERWAL: It sits there and ekes out gradually into the blood flow from this slow release capsule, if you like, that's sitting under the skin and it pretends to the body that it's pregnant. So, people can't actually get pregnant while they're on it and it's very effective and works very well and, people find it a great help to them in their lifestyle.

HENRY: So how many women would have taken up this method of contraception in recent years?

HAIKERWAL: In Australia in the last two years, about 160,000 ladies have taken it on.

HENRY: Crikey.

HAIKERWAL: Yes. It was something totally different to pills and injections and condoms and actually, it's actually a lot safer than some forms of actual tubal ligation where you - you know, sterilisation procedures.

HENRY: So given the fact that 160,000 Australian women are probably using this method, what's your advice to them in regards to making sure that they examine it thoroughly?

HAIKERWAL: Step one is to feel where you were shown that it was put in the first place, to make sure it's still there and if it's still there you're fine, as long as you're within your three years. And if anybody's having one put in new, obviously they need to know where it is to feel for, for future reference and obviously, the doctor will feel to make sure it's there before letting you go, to say that you're now protected by this particular birth control.

HENRY: When you say feeling under the arm there to make sure it's there, is the problem that sometimes the doctor thinks that they've implanted it and, in fact, they haven't?

HAIKERWAL: That would seem to be what was in the publication that came out at the weekend, that some people may not have actually had it under their skin because it wasn't actually there and that's why it is just so important to check that it's there after placing it in.

It's fine just under the skin. If you think about the fold of the elbow, you look at it from the palm side and about a finger's length in from that elbow joint and if you just roll - it's just inside a muscle there, this sort of loose skin, it's just popped in there so it's very easy to feel and it's very important to know where it is so that you can be sure that it's there.

HENRY: Okay, so once you leave the doctor's surgery, just a little bit of firm pressure to say, 'Okay, I can actually feel that'. I suppose it's just like a raised nodule, is it?

HAIKERWAL: Not even that. It's like a little match - a thin matchstick that you can roll, like a little rod, under the arm.

It's very good, it's very effective, it's very safe and people who use it love it because it means there's less worrying to do. The problem with any sort of device is that nothing is ever 100% but compared to the list of things that we use for contraception, this is the best and it's very safe and very effective, used properly.

HENRY: Interesting area. Thanks for talking to us.

HAIKERWAL: You're very welcome.

HENRY: There's Dr Mukesh Haikerwal, this afternoon, in regards to that particular method of contraception that, you just heard the doctor tell us, 160,000 Australian women are using that particular method and you just need to have a, I suppose, a self-examination with that spot just near your elbow where it is implanted to make sure that you can feel it because there have been some reports. There have been 47 pregnancies reported supposedly after doctors have not inserted the device correctly. So it's up to the ladies, I suppose, to check, once you've been to the quack, just to have it put in. Just do your own check and make sure you can feel it, as Dr Mukesh said there.

Ends