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Explore the Handbook
Introduction
Welcome to FPHandbook.org!
Foreword From the World Health Organization
Foreword From the United States Agency for International Development
Acknowledgements
WHO’s Family Planning Guidance
Human Rights: Family Planning Providers’ Contribution
Gender Equality and Gender Inclusiveness
Gender Inclusiveness
Considerations for Transgender and Gender-Diverse Clients
References for the Section on Gender Equality and Gender Inclusiveness
Collaborating and Supporting Organizations
Chapters
Combined Oral Contraceptives
Side Effects, Health Benefits, and Health Risks
Correcting Misunderstandings
Facts About Combined Oral Contraceptives and Cancer
Who Can and Cannot Use Combined Oral Contraceptives
Medical Eligibility Criteria for Combined Oral Contraceptives
Using Clinical Judgment in Special Cases
Providing Combined Oral Contraceptives
Giving Advice on Side Effects
Explaining How to Use
Supporting New and Continuing Users
Come Back Any Time: Reasons to Return
Managing Any Problems
Extended and Continuous Use of Combined Oral Contraceptives
Questions and Answers About Combined Oral Contraceptives
Progestin-Only Pills
Side Effects, Health Benefits, and Health Risks
Correcting Misunderstandings
Who Can and Cannot Use Progestin-Only Pills
Medical Eligibility Criteria for Progestin-Only Pills
Using Clinical Judgment in Special Cases
Providing Progestin-Only Pills
Giving Advice on Side Effects
Explaining How to Use
Supporting New and Continuing Users
“Come Back Any Time”: Reasons to Return
Managing Any Problems
Questions and Answers About Progestin-Only Pills
Emergency Contraceptive Pills
Side Effects, Health Benefits, and Health Risks
Correcting Misunderstandings
Who Can Use Emergency Contraceptive Pills
Providing Emergency Contraceptive Pills
Pill Formulations and Dosing
Giving Emergency Contraceptive Pills
How Can a Partner Help?
When to Start or Restart Contraception After ECP Use
Supporting Users
Questions and Answers About Emergency Contraceptive Pills
Progestin-Only Injectables
How Effective?
Side Effects, Health Benefits, and Health Risks
Correcting Misunderstandings
Delivering Injectable Contraception in the Community
Who Can and Cannot Use Progestin-Only Injectables
Medical Eligibility Criteria for Progestin-Only Injectables
Using Clinical Judgment in Special Cases
Providing Progestin-Only Injectables
Giving Advice on Side Effects
Giving Intramuscular Injection with a Conventional Syringe
Giving the Injection with Subcutaneous DMPA in Uniject (Sayana Press)
Self-Injection Can Be an Option
How to Give Yourself an Injection with Sayana Press
Supporting New and Continuing Users
Managing Any Problems
Questions and Answers About Progestin-Only Injectables
Monthly Injectables
How Effective?
Side Effects, Health Benefits, and Health Risks
Correcting Misunderstandings
Who Can and Cannot Use Monthly Injectables
Medical Eligibility Criteria for Monthly Injectables
Using Clinical Judgment in Special Cases
Providing Monthly Injectables
Giving Advice on Side Effects
Giving the Injection
Supporting New and Continuing Users
Managing Any Problems
Questions and Answers About Monthly Injectables
Combined Patch: Only the Essentials
How Effective?
Side Effects, Health Benefits, and Health Risks
Providing the Combined Patch
Supporting New and Continuing Users
Combined Vaginal Ring: Only the Essentials
How Effective?
Side Effects, Health Benefits, and Health Risks
Providing the Combined Vaginal Ring
Supporting New and Continuing Users
Progesterone-Releasing Vaginal Ring: Only the Essentials
How Effective?
Side Effects, Health Benefits, and Health Risks
Providing the Progesterone-Releasing Vaginal Ring
Supporting New and Continuing Users
Implants
How Effective?
Side Effects, Health Benefits, and Health Risks
Correcting Misunderstandings
Who Can and Cannot Use Implants
Medical Eligibility Criteria for Implants
Using Clinical Judgment in Special Cases
Providing Implants
Giving Advice on Side Effects
Inserting Implants
Supporting New and Continuing Users
Follow-up Visits With Implant Users
Managing Any Problems
New Problems That May Require Switching Methods
Removing Implants
Questions and Answers About Implants
Copper-Bearing Intrauterine Device
How Effective?
Side Effects, Health Benefits, Health Risks, and Complications
Correcting Misunderstandings
Who Can and Cannot Use the Copper-Bearing IUD
Medical Eligibility Criteria for Copper-Bearing IUDs
Using Clinical Judgment in Special Cases
Screening Questions for Pelvic Examination Before IUD Insertion
Assessing Women for Risk of Sexually Transmitted Infections
Providing the Intrauterine Device
Preventing Infection at IUD Insertion
Giving Advice on Side Effects
Inserting the IUD
Supporting New and Continuing Users
"Come Back Any Time": Reasons to Return
Post-Insertion Follow-Up Visit (3 to 6 Weeks)
Managing Any Problems
New Problems That May Require Switching Methods
Removing the Intrauterine Device
Switching From an IUD to Another Method
Questions and Answers About the Intrauterine Device
Levonorgestrel Intrauterine Device
How Effective?
Side Effects, Health Benefits, Health Risks, and Complications
Correcting Misunderstandings
Who Can and Cannot Use Levonorgestrel IUDs
Medical Eligibility Criteria for Levonorgestrel IUDs
Using Clinical Judgment in Special Cases
Screening Questions for Pelvic Examination Before IUD Insertion
Assessing Women for Risk of Sexually Transmitted Infections
Providing the Levonorgestrel Intrauterine Device
Giving Advice on Side Effects
Inserting the LNG-IUD
Supporting New and Continuing Users
"Come Back Any Time": Reasons to Return
Post-Insertion Follow-Up Visit (3 to 6 Weeks)
Managing Any Problems
New Problems That May Require Switching Methods
Removing the Intrauterine Device
Switching From an IUD to Another Method
Questions and Answers About the LNG-IUD
Female Sterilization
How Effective?
Side Effects, Health Benefits, Health Risks, and Complications
Correcting Misunderstandings
Who Can Have Female Sterilization
Medical Eligibility Criteria for Female Sterilization
Providing Female Sterilization
Ensuring Informed Choice
Performing the Sterilization Procedure
Supporting the User
"Come Back Any Time": Reasons to Return
Managing Any Problems
Managing Ectopic Pregnancy
Questions and Answers About Female Sterilization
Vasectomy
How Effective?
Side Effects, Health Benefits, Health Risks, and Complications
Correcting Misunderstandings
Who Can Have a Vasectomy
Medical Eligibility Criteria for Vasectomy
Providing Vasectomy
Vasectomy Techniques
Performing the Vasectomy Procedure
Supporting the User
"Come Back Any Time": Reasons to Return
Managing Any Problems
Questions and Answers About Vasectomy
Male Condoms
How Effective?
Side Effects, Health Benefits, and Health Risks
Bringing Up Condom Use
Correcting Misunderstandings
Who Can and Cannot Use Male Condoms
Providing Male Condoms
What Condom Users Should Not Do
Lubricants for Latex Condoms
Supporting New and Continuing Users
"Come Back Any Time": Reasons to Return
Managing Any Problems
New Problems That May Require Switching Methods
Questions and Answers About Male Condoms
Female Condoms
How Effective?
Side Effects, Health Benefits, and Health Risks
Correcting Misunderstandings
Who Can Use Female Condoms
Providing Female Condoms
Lubricants for Female Condoms
Supporting New and Continuing Users
"Come Back Any Time": Reasons to Return
Managing Any Problems
Questions and Answers About Female Condoms
Spermicides and Diaphragms
How Effective - Spermicides?
Side Effects, Health Benefits, and Health Risks - Spermicides
Correcting Misunderstandings - Spermicides
Who Can and Cannot Use Spermicides
Providing Spermicides
Supporting the Spermicide User
Diaphragms
How Effective - Diaphragms?
Side Effects, Health Benefits, and Health Risks - Diaphragms
Correcting Misunderstandings - Diaphragms
Who Can and Cannot Use Diaphragms
Using Clinical Judgment in Special Cases of Diaphragm Use
Providing Diaphragms
Explaining the Fitting Procedure
Explaining How to Use the Diaphragm
Supporting the Diaphragm User
Tips and Follow-up for Users of Spermicides and the Diaphragm
Managing Any Problems
Questions and Answers About Spermicides and Diaphragms
Cervical Caps: Only the Essentials
How Effective?
Side Effects, Health Benefits, and Health Risks
Providing Cervical Caps
Fertility Awareness Methods
How Effective?
Side Effects, Health Benefits, and Health Risks
Correcting Misunderstandings
Who Can Use Calendar-Based Methods
Providing Calendar-Based Methods
Explaining How to Use Calendar-Based Methods
Who Can Use Symptoms-Based Methods
Providing Symptoms-Based Methods
Explaining How to Use Symptoms-Based Methods
Supporting New and Continuing Users
Managing Any Problems
Questions and Answers About Fertility Awareness Methods
Withdrawal: Only the Essentials
How Effective?
Who Can and Cannot Use Withdrawal
Using Withdrawal
Lactational Amenorrhea Method
How Effective?
Side Effects, Health Benefits, and Health Risks
Correcting Misunderstandings
Who Can Use the Lactational Amenorrhea Method
The Lactational Amenorrhea Method for Women With HIV
Providing the Lactational Amenorrhea Method
When Can a Woman Use LAM?
Explaining How to Use
Supporting New and Continuing Users
Managing Any Problems
Questions and Answers About the Lactational Amenorrhea Method
Serving Diverse Groups
Adolescents
All Contraceptives Are Safe for Young People
Men
Many Ways to Help Men
Women Near Menopause
When a Woman Can Stop Using Family Planning
Relieving Symptoms of Menopause
Clients with Disabilities
Sexually Transmitted Infections, Including HIV
Who Is at Risk for STIs?
What Causes STIs?
Symptoms of Sexually Transmitted Infections
Common Vaginal Infections That May Not Be Sexually Transmitted
Avoiding STIs
Contraceptives for Clients with STIs, Including HIV
Cervical Cancer
Questions and Answers About STIs, Including HIV
Family Planning for Adolescents and Women at High Risk for HIV
Maternal and Newborn Health
Planning Pregnancy
During Pregnancy
Planning for Family Planning After Delivery
Preparing for Childbirth and Complications
After Childbirth
Earliest Time That a Woman Can Start a Family Planning Method After Childbirth
Preventing Mother-to-Child Transmission of HIV
Managing Any Breastfeeding Problems
Reproductive Health Issues
Family Planning in Postabortion Care
Help Women Obtain Family Planning
When to Start Contraceptive Methods
Violence Against Women
What Can Providers Do?
Infertility
Preventing Involuntary Infertility
Counseling Clients With Fertility Problems
Family Planning Provision
Successful Counseling
Who Provides Family Planning?
Infection Prevention in the Clinic
Make Infection Prevention a Habit
Managing Contraceptive Supplies
Providing Family Planning Services During an Epidemic
APPENDIXES
APPENDIX A - Contraceptive Effectiveness
APPENDIX B - Signs and Symptoms of Serious Health Conditions
APPENDIX C - Medical Conditions That Make Pregnancy Especially Risky
APPENDIX D - Medical Eligibility Criteria for Contraceptive Use
PERSONAL CHARACTERISTICS AND REPRODUCTIVE HISTORY
CARDIOVASCULAR DISEASE
NEUROLOGICAL CONDITIONS
REPRODUCTIVE TRACT INFECTIONS AND DISORDERS
HIV/AIDS
OTHER INFECTIONS
ENDOCRINE CONDITIONS
GASTROINTESTINAL CONDITIONS
ANEMIAS
DRUG INTERACTIONS
ADDITIONAL CONDITIONS
Glossary, Methodology, and WHO Guidance Document
Glossary
Methodology
WHO Guidance Documents Used in Preparation of This Edition of the Handbook
Job Aids
Comparing Combined Methods
Comparing Injectables
Comparing Implants
Comparing Condoms
Comparing IUDs
If You Miss Pills
Female Anatomy
External Anatomy
The Menstrual Cycle
Male Anatomy
Identifying Migraine Headaches and Auras
Can a Woman With Migraines and/or Aura Use a Hormonal Method?
Considering Progestin-Only Injectables Where HIV Risk Is High: Counseling Tips
Ruling Out Pregnancy
How and When to Use the Pregnancy Checklist and Pregnancy Tests
Pregnancy Checklist
Comparing Effectiveness of Family Planning Methods
Family Planning
A Global Handbook for Providers
Order
ANEMIAS
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