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Common Healthcare Challenges
Questions that patients might ask you are covered in the Common questions about contraception “Common questions about contraception”
section of this website.
Further information about when and how to use a number of types of contraception you may be asked about or wish to consider for your patients can be found in the accompanying World Health Organization document entitled: Selected practice recommendations for contraceptive use (second edition).2 The recommendations contained within this document were the Expert Working Group’s response to 33 specific questions selected by WHO. These questions were selected based on 1) important controversies or inconsistencies in existing guidance, 2) the likelihood that relevant evidence was available, and 3) proposals from expert Working Group participants and family planning organizations/agencies.
The document provides selected practice recommendations based on the best available evidence and is intended to be used by policy-makers, programme managers, and the scientific community. It aims to provide guidance to national family planning/reproductive health programmes in the preparation of guidelines for service delivery of contraceptives. The document covers the following family planning methods: combined oral contraceptives (COCs), combined injectable contraceptives (CICs), progestin-only pills (POPs), depot medroxyprogesterone acetate (DMPA), norethisterone enantate (NET-EN), levonorgestrel implants, emergency contraceptive pills (ECPs), copper-bearing intrauterine devices, levonorgestrel-releasing intrauterine devices (LNG IUDs), fertility awareness-based methods, and sterilization. The specific questions that are considered are:
- When can a woman start combined oral contraceptives (COCs)?
- When can a woman start combined injectable contraceptives (CICs)?
- When can a woman have repeat combined injectable contraceptive injections (CICs)?
- When can a woman start progestin-only pills (POPs)?
- When can a woman start progestin-only injectables (POIs) – depot medroxyprogesterone acetate (DMPA) or norethisterone enantate (NET-EN)?
- When can a woman have repeat progestin-only injectables (POIs) – depot medroxyprogesterone acetate (DMPA) or norethisterone enantate (NET-EN)?
- When can a woman start using an implant?
- How long can levonorgestrel implants be left in place?
- When can a woman have a copper-bearing IUD inserted?
- Should prophylactic antibiotics be provided for copper-bearing IUD insertion?
- When can a woman have a levonorgestrel-releasing IUD (LNG IUD) inserted?
- Should prophylactic antibiotics be provided for levonorgestrel-releasing IUD (LNG IUD) insertion?
- How can a woman take emergency contraceptive pills (ECPs)?
- Can a woman receive an advance supply of emergency contraceptive pills (ECPs)?
- When can a man rely on his vasectomy for contraception?
- What can a Standard Days Method (SDM) user do if she has menstrual cycles outside the26–32 day range?
- What can a woman do if she misses combined oral contraceptives (COCs)?
- What can a woman do if she misses progestin-only pills (POPs)?
- What can a woman do if she vomits and/or has severe diarrhoea while using combined oral contraceptives (COCs) or progestin-only pills (POPs)?
- What can a woman do to prevent nausea and vomiting when taking emergency contraceptive pills (ECPs)?
- What can a woman do if she vomits after taking emergency contraceptive pills (ECPs)?
- What can be done if a woman has menstrual abnormalities when using a progestin-only injectable (POI) – depot medroxyprogesterone acetate (DMPA) or norethisterone enantate (NET-EN)?
- What can be done if a woman experiences menstrual abnormalities when using implants?
- What can be done if a woman experiences menstrual abnormalities when using a copper-bearing IUD?
- What can be done if a woman experiences menstrual abnormalities when using a levonorgestrel-releasing IUD (LNG IUD)?
- What should be done if a woman using a copper-bearing IUD is diagnosed with pelvic inflammatory disease (PID)?
- What should be done if a woman using a levonorgestrel-releasing IUD (LNG IUD) is diagnosed with pelvic inflammatory disease (PID)?
- What should be done if a woman using a copper-bearing IUD is found to be pregnant?
- What should be done if a woman using a levonorgestrel-releasing IUD (LNG IUD)is found to be pregnant?
- What examinations or tests should be done routinely before providing a method of contraception?
- How many pill packs (combined or progestin-only pills) should be given at initial and return visits?
- What follow-up is appropriate for combined oral contraceptive (COCs), progestin-only pill (POPs), implant and IUD users?
- How can a provider be reasonably sure that a woman is not pregnant?
Further information.
For a full copy of the document, please follow the following link: http://www.who.int »
References
- Family Planning Association. Contraception and sexual health guide. Accessed on 1 April 2005 at: http://www.fpa.org.uk/information/leaflets/.
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