There are many different methods of contraception available that are outlined in detail below. Contraception is important to prevent unwanted pregnancies, and should be used until the menopause. Choosing a method of contraception that is right for you is a very important decision.

1) Contraceptive Implant (Nexplanon)

Nexplanon is a small flexible single rod that is inserted just under the skin on the inside of the upper arm. It is the size of a matchstick, and releases low daily dose of a hormone called etonogestrel for up to 3 years. It is a very effective (over 99%) contraceptive that does not affect your fertility. If you wish to conceive in the future, your fertility returns as soon as the implant is removed.

What are the advantages of using a contraceptive implant?

• You do not have to remember to take a pill every day.
• It lasts for three years and does not interfere with sex.
• It can be used when breast-feeding.
• Period pain is usually less.
• It can used by some women who are unable to use contraception containing oestrogen.

What are the disadvantages of using a contraceptive implant?

• Often causes changes to the pattern of your periods, and some patients have irregular bleeding.
• Periods can sometimes be heavier and last longer with the implant.
• It does not protect against sexually transmitted infections (STI’s), so you also need to use condoms.

If you wish to have Nexplanon inserted or removed, you should book an appointment with Dr Hughes. Nexplanon is best fitted during the first 5 days of your period. Please note that you will need to book an appointment for counselling about the procedure before your Nexplanon can be inserted. 

2) Intra-uterine Device (IUD or Copper Coil)

An IUD is a small plastic and copper device with threads on the end that is put into your womb (also called uterus). The thin threads hang through the opening at the entrance of your uterus called your cervix into the top of your vagina. An IUD can stay in for 5–10 years, depending on the type. If you are aged 40 or older when the IUD is fitted, it can be left in until the menopause.

What are the advantages of using an IUD?

• It is effective as soon as it is inserted.
• It works for 5–10 years depending on the type of coil.
• It does not affect sex.
• It can be used if you are breast-feeding.
• Your fertility returns to normal as soon as the IUD is taken out.
• It can be used as a form of emergency contraception.

What are the disadvantages of an IUD?

• Periods can sometimes become heavier, longer or more painful with the coil.
• It does not protect you from sexually transmitted infections, so you also need to use condoms.
• Perforation (puncture of the wall of the womb) may rarely occur at the time of insertion.
• Rarely infection and bleeding at the time of insertion can occur.
• Expulsion of the coil from the womb can occur, often in the first month after insertion.
• If you do become pregnant while you are using an IUD there is a small increased risk of you having an ectopic pregnancy (fetus growing outside of the womb).

If you wish to have an IUD inserted or removed, you should book an appointment at Chalmers Hospital by visit their website.

3) Intra-uterine System (IUS or Mirena Coil)

The IUS is a small, soft, flexible plastic system that is placed in the womb to prevent pregnancy. It can be used up to 5 years.

What are the advantages of using an IUS?

• You do not have to remember to take a pill every day.
• It lasts for up to five years and does not interfere with sex.
• It can be used when breast-feeding.
• Period pain is usually less, and the IUS is a recommended treatment for heavy painful periods.
• It can used by some women who are unable to use contraception containing oestrogen.
• If you wish to conceive in the future, your fertility returns to normal after removal of the IUS.

What are the disadvantages of using a contraceptive implant?

• Often causes changes to the pattern of your periods, and some patients have irregular bleeding.
• Perforation of the womb, bleeding and infection may rarely occur at the time of insertion.
• Expulsion of the coil from the womb can occur, often in the first month after insertion.
• Pelvic or abdominal pain.
• Headache.
• Breast tenderness.
• Skin changes (acne).
• It does not protect against STI’s, so you also need to use condoms.

If you wish to have an IUS inserted or removed, you should book an appointment at Chalmers Hospital by visiting their website .

4) Combined Oral Contraceptive Pill (COCP)

The combined pill contains two hormones (oestrogen and progestogen) that are similar to the natural hormones women produce in their ovaries. If the pill is taken according to instructions it is over 99 per cent effective. There are a wide variety of pills available, but generally you take the pill for 21 days then have 7 days when you have a pill free week. During this pill free week, you will have a withdrawal bleed like a period.

What are the advantages of the pill?

• Does not interrupt sex.
• Your periods usually become regular, lighter and less painful.
• It can reduce premenstrual symptoms.
• Reduces the risk of cancer of the ovary, uterus and colon.
• Reduces acne in some women.
• Reduces the risk of fibroids, ovarian cysts and non-cancerous breast disease.

What are the disadvantages of the pill?

• There are several side effects including headaches, nausea, breast tenderness and mood changes.
• May increase your blood pressure.
• Does not protect you against sexually transmitted infections.
• You often experience break-through bleeding or spotting.
• Cannot be used in breast-feeding women and some women with certain health problems.
• Increases the risk of blood clots (venous thrombosis), heart disease and stroke.
• Small increase in the risk of being diagnosed with breast cancer.
• Small increase in the risk of developing cervical cancer with longer use of the COCP.

5) Progestogen-Only Pill (Mini-Pill or POP)

The progestogen-only pill (POP) contains a progestogen hormone that is similar to the natural progesterone women produce in their ovaries. Progestogen-only pills are different to combined pills because they do not contain any oestrogen. This pill needs to be taken at the same time every day, and unlike the COCP there is no break with this pill.


What are the advantages of the POP?

• Does not interrupt sex.
• Your periods usually become regular, lighter and less painful.
• It can be used if you are breast-feeding.
• It can be taken by women who are unable to take oestrogens.
• You are able to use it at any age regardless if you smoke.
• It can reduce pre-menstrual symptoms.

What are the disadvantages of the POP?

• Your periods may become irregular or more frequent while you are taking the POP.
• Does not protect you against sexually transmitted infections.
• You have to remember to take the pill at the same time every day with no break.
• Common temporary side effects include acne, breast tenderness, weight change and headaches.

6) Contraceptive injection (also known as Depot or Depo-Provera)

The contraceptive injection contains a progestogen hormone that is similar to the natural progesterone that women produce in their ovaries, and is given in your buttock. Depo-Provera protects you from pregnancy for 12 weeks and is over 99 per cent effective.

What are the advantages of a contraceptive injection?

• It lasts for 3 months and does not interrupt sex.
• It can be used when breast-feeding.
• It is not affected by other medications.
• Reduces heavy painful periods and it can help with premenstrual symptoms for some women.
• It can be used by women who are unable to use contraception containing the hormone oestrogen.

What are the disadvantages of a contraceptive injection?

• Irregular bleeding is common, and may continue for some months after you stop the injections.
• Weight gain is a common side effect of the depot.
• Delay of up to a year before the return of your periods and fertility after stopping the depot.
• Does not protect you against sexually transmitted infections.
• Risk of infection at the site of the injection.
• May affect your bones by causing thinning of your bones.

7) Emergency Contraception

If you have had unprotected sex, that is, sex without using contraception, or think your contraception might have failed, you can use emergency contraception. There are two different types of emergency contraception:

1) Emergency contraceptive pill called Levonelle (also known as the Morning After Pill):

• This pill can be taken up to 72 hours after sex.
• It is more effective the sooner that the pill is taken after sex.

2) Emergency intra-uterine device (IUD):

• This can be inserted up to 5 days after sex.
• It can remain in the womb to provide long-term contraception if desired.

Emergency contraception can be very effective especially if you have an IUD fitted or if the emergency contraceptive pill is taken soon after sex. You should see your GP, Practice Nurse or Pharmacist as soon as possible if you are worried about unprotected sex. We are unable to offer the fitting of the IUD at the Surgery. Should you wish this form of contraception, please urgently contact Chalmers Hospital direct on 0131 536 1070.

You can also visit www.barclaymedicalplus.com for Coil and Implants. Click on the link or scan the QR code below.

Chalmers have set up a new clinic for Coils and Implants. This clinic runs on Tuesday evenings with no advanced booking required.

A cervical smear test is a method of detecting abnormal (pre-cancerous) cells in the neck of the womb called the cervix. These tests are performed in order to prevent cervical cancer in women. The vast majority of women have normal smear test results, but for 1 in 20 women, the test will show some abnormal changes in the cells in the cervix. A very few of these cases will require treatment to prevent them from becoming cancerous.

In Scotland all women aged between 25 and 64 are invited for cervical screening every five years. It is estimated that early detection and treatment can prevent up to 8 out of 10 cervical cancers. For further information about the cervical smear programme in Scotland, please click here.

If you would like to arrange your smear test, please phone Reception to book an appointment with one of our experienced Practice Nurses on 01875 610248.

The Practice offers appointments for private medicals, such as for insurance policies and HGV licenses. Please inform the Receptionist when you telephone for an appointment, as this usually requires a 30-minute appointment, and ask for the up-to-date charge for this. Details of these charges are available from Reception, and are made in line with the British Medical Association (BMA) recommendations. GPs complete many forms covering a wide range of things, such as insurance reports, DVLA reports, occupational health reports, critical illness insurance, life insurance and cancellation of holidays. Before we can complete these requests, we need your signed consent. As completion of these reports is out with our NHS responsibility, we charge a fee for this work and details of this can be obtained from Reception.

The delivery of Travel Vaccines in Scotland is changing.

To try and help manage the GP workload and make sure GPs are using their skills in the best way the Scottish Government along with the GPs agreed that giving vaccination should be moved away from General Practice.

When travelling abroad, it is important to prevent illness by ensuring that you are immunized appropriately and are taking anti-malarial medications if applicable. For more information or to make an appointment please visit https://weare.nhslothian.scot/travelclinics/ or call 0131 537 2823.

Please note that some vaccines and services are chargeable. Full price list is on the above website.

Babies generally have their first vaccines at their 6-8 week baby check appointment with a Health Visitor. If you have questions about any aspect of the immunisation programme, please speak to your Health Visitor.  For further information about the UK Immunisation schedule, please visit their website at http://immunisation.dh.gov.uk/

Warts and verrucae are very common, and are caused by a wart virus. They are slow growing and may gradually spread, but are not dangerous to your health. Left alone, warts and verrucae will eventually disappear of their own accord.

Recent research has shown that regular daily treatment with salicylic acid is the best way to treat warts and is more effect than cryotherapy. We therefore recommend using Salctol or Salactac every day on warts and verrucae. Please note that this treatment may have to be continued for up to 3 months.

All staff at Ormiston Medical Practice recognise the important and valuable contribution made by carers. A carer is defined as a person irrespective of age who, without payment, provides help and support on a regular basis to a relative, partner, friend or neighbour of any age affected by physical or mental illness (often long-term), disability, frailty or substance misuse.

Carers play a crucial role in the delivery of health and social care provision in Scotland. There are approximately 657,300 identified carers in Scotland that equates to 1 in 8 of the population. We actively strive to identify and support carers and those being cared for in the local community. If you are a carer, please advise our Reception team of this on 01875 610248.

Carers of East Lothian supports all adults in a caring situation in East Lothian to get information and services to help their individual caring role, enhance their own wellbeing, and strengthen their collective voice to improve services.
You can contact them on 0131 665 0135 or visit their website by clicking here.

Mental health problems cover a wide spectrum of illnesses, and can interfere with the ability to cope on a daily basis. We offer patients with chronic mental health problems an annual check up of their physical health, such as blood pressure check, weight and blood tests. If applicable, you will be sent a letter inviting you for this to be done by the GP once a year.

Epilepsy is defined as a tendency to have recurrent seizures (sometimes called fits). A seizure is caused by a sudden burst of excessive electrical activity in the brain, causing a temporary disruption in the normal message passing between brain cells. This disruption results in the brain’s messages becoming halted or mixed up. If you have confirmed Epilepsy, you will be invited by letter for review by a GP each year. At this check, the GP will:

• Discuss your symptoms and the impact your symptoms are having on you
• Review how often you are having seizures
• Review your medications, and any side effects that you have
• Provide advice and answer any questions that you may have

Chronic Kidney Disease (CKD) is a long-term abnormality of the kidneys that means that your kidneys are not working as well as they once did. The severity of the disease is classified into five stages 1-5 with most people in the mild stage. If you have mild or moderate kidney disease, you are unlikely to have any symptoms and it is unlikely to progress to kidney failure.

CKD is important to identify at any stage as it increases the risk of developing heart disease or a stroke. By identifying this condition, we can give you medications to reduce this risk. If you have confirmed CKD, you will be invited by letter for a review by a Practice Nurse each year. At this check, the Practice Nurse will:

• Discuss any symptoms that you may have
• Check your weight, height and blood pressure
• Take blood samples to check your kidney function, blood count, cholesterol level and sugar level
• Check your urine for protein, so please bring a fresh urine specimen to your appointment
• Discuss your diet, lifestyle and alcohol intake
• Provide help with stopping smoking if applicable