IUD and implant follow-up care for expats in the EU

You had an IUD or a contraceptive implant fitted years ago, in the country you used to live in. It was handled, you stopped thinking about it. Then you moved to Spain, and a quiet question surfaced: who is looking after this now? How long is it actually licensed for, what if something feels different, and what happens when it needs replacing?

It is a reasonable question to have, and a common one among women who relocate. Long-acting contraception is designed to be low-maintenance, not no-maintenance. Here is what follow-up care involves and what can be done by video.

What routine follow-up covers

For most devices, follow-up is light:

• Knowing your device's dates. IUDs are licensed for different durations depending on type (hormonal or copper) and brand — often between 3 and 10 years. The implant is typically licensed for around 3 years. If you do not know your insertion date, that is the first thing to pin down; the letter or card from your fitting clinic, or your old GP's records, will have it.
• Checking you can feel the strings. After an IUD is fitted, you were probably shown how to check the strings with a finger. Doing this occasionally, especially in the first months and after any episode of heavy bleeding, is the main self-check there is.
• Reviewing how your body is doing. Changed bleeding patterns, pelvic pain, or side effects you are not sure are normal are all legitimate reasons for a review — not signs you are being difficult.

What a video consultation can do

A video GP can genuinely help with the conversation part: reviewing your device dates and history, discussing symptoms and what they might mean, answering questions about side effects, and planning what happens next. Where clinically appropriate, following a genuine evaluation, a doctor can also discuss and issue prescriptions for non-device contraception, so you have a bridge while you arrange device care locally.

What video cannot do is examine you. Insertion, replacement, and removal of an IUD or implant are physical procedures — they need an in-person clinician, and in Spain those are available through gynaecology services, private clinics, or family-planning centres depending on your situation and insurance.

When to seek care promptly

Some symptoms are not routine follow-up material. Seek urgent in-person care — an urgent care service or emergency department, or call 112 if severe — for:

• Pelvic pain that is severe or getting worse, or pain with fever.
• Heavy bleeding that is soaking protection hourly, or bleeding with dizziness.
• Signs of pregnancy with pain on one side (which needs urgent assessment if you have a device in place).
• You cannot feel the IUD strings at all, or you can feel the hard plastic of the device.
• For the implant: redness, swelling, or pain at the insertion site.

These are not common, and having a device does not mean something is wrong — but each of these is a same-day conversation with a clinician who can examine you, not a video call.

Planning device replacement in Spain

If your device is at or near its licensed end date, plan ahead rather than waiting for it to run out:

1. Confirm the insertion date and device type from your old records; a video GP can help you interpret them and plan timing.
2. Ask local clinics what they offer — public system routes depend on your registration and region; private gynaecology clinics offer same-week appointments, and some allow you to bring a device obtained with a prescription.
3. Keep contraception covered in the gap. This is exactly the bridge conversation a video GP can have with you.

Long-acting contraception abroad is mostly a paperwork-and-planning problem, and planning is what consultations are for. If you want a review of your device dates, your symptoms, or your options in Spain, book a video consultation with an English-speaking GP and bring whatever records you have — even a photo of the old insertion card is a useful start.