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A family planning provider in El Salvador uses a diagram of a woman's reproductive organs to describe how different family planning methods affect a woman's menstrual cycle. (Photo: ©2003 Paul J. Crystal, Courtesy of Photoshare)
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 KEY POINTS
Changes in vaginal bleeding make more women stop using hormonal family planning methods or IUDs than any other method-related reason, and sometimes bleeding changes are the most common reason overall. When women are considering these methods, informing and counseling them about bleeding changes helps them choose methods that suit them, and it helps them know what to expect. If the methods cause bothersome bleeding changes, managing the problems can help women continue to prevent unwanted pregnancy effectively. In fact, addressing bleeding changes may be the most important way that family planning providers can help users of these methods.
Combined hormonal methods usually make monthly bleeding lighter and more predictable. Progestin-only methods can cause bleeding changes that range from spotting and bleeding at unexpected times to no monthly bleeding. Copper IUDs can cause somewhat heavier and longer monthly bleeding.
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These steps can help new clients decide whether to choose a family planning method that may change monthly bleeding:
- Describe the common bleeding changes in ways that clients understand, including how the changes may vary over time.
- Explain that such bleeding changes are normal with these contraceptives. They are not harmful, and they are not signs of illness.
- Help each client consider how she would feel and what she would do if these bleeding changes happened to her.
- Invite her to return any time that she has concerns.
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These steps can help continuing clients manage bleeding changes caused by a family planning method:
- In the first few months of use, explain that the changes probably will lessen with time.
- If the bleeding changes persist, or at any time a client asks, offer available treatments to relieve the bleeding changes.
- At any time a client finds bleeding changes unacceptable, help her choose a method that better suits her.
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How To Use This Report
Family planning providers can use this report to:
Programs and organizations can use this report to:
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See companion INFO Reports, "Key Facts About the Menstrual Cycle