Persistent vaginal bleeding in a patient with a broken Implanon

A 29-year-old woman with an Implanon contraceptive device in situ presented with persistent and prolonged vaginal bleeding. The implant had been inserted 2 years previously; the patient had been happy with it and had been mainly amenorrhoeic with the occasional light period. She was concerned that the implant had broken during a game of 'rough and tumble' with her son in August 2000. Since the trauma to her arm her bleeding pattern had changed, and she began bleeding heavily for 3 weeks every month. The rod was removed and found to be fractured halfway across its width. A new Implanon device was inserted and the bleeding settled.