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Explore the Handbook
Introduction
Welcome to FPHandbook.org!
From the World Health Organization
From the United States Agency for International Development
Acknowledgements
Collaborating and Supporting Organizations
WHO’s Family Planning Guidance
Human Rights: Family Planning Providers’ Contribution
How to Obtain More Copies of This Book
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 the User
Come Back Any Time: Reasons to Return
Helping Continuing Users
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 (see also Questions and Answers)
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 the User
“Come Back Any Time”: Reasons to Return
Helping Continuing Users
Managing Any Problems
Questions and Answers About Progestin-Only Pills
Emergency Contraceptive Pills
Side Effects, Health Benefits, and Health Risks
Correcting Misunderstandings (see also Questions and Answers)
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
Helping Users
Questions and Answers About Emergency Contraceptive Pills
Progestin-Only Injectables
How Effective?
Side Effects, Health Benefits, and Health Risks
Correcting Misunderstandings (see also Questions and Answers)
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)
Supporting the User
Teaching Clients to Self-Inject
How to Give Yourself an Injection with Sayana Press
How Can a Partner Help?
Helping Continuing Users
Managing Late Injections
Managing Any Problems
New Problems That May Require Switching Methods
Questions and Answers About Progestin-Only Injectables
Monthly Injectables
How Effective?
Side Effects, Health Benefits, and Health Risks
Correcting Misunderstandings (see also Questions and Answers)
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 the User
Helping Continuing Users
Managing Late Injections
Managing Any Problems
New Problems That May Require Switching Methods
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 the User
Combined Vaginal Ring: Only the Essentials
How Effective?
Side Effects, Health Benefits, and Health Risks
Providing the Combined Vaginal Ring
Supporting the User
Progesterone-Releasing Vaginal Ring: Only the Essentials
How Effective?
Side Effects, Health Benefits, and Health Risks
Providing the Progesterone-Releasing Vaginal Ring
Supporting the User
Implants
How Effective?
Side Effects, Health Benefits, and Health Risks
Correcting Misunderstandings (see also Questions and Answers)
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 the User
Removing Implants
Helping Continuing Users
Managing Any Problems
New Problems That May Require Switching Methods
Questions and Answers About Implants
Copper-Bearing Intrauterine Device
How Effective?
Side Effects, Health Benefits, Health Risks, and Complications
Correcting Misunderstandings (see also Questions and Answers)
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
Explaining the Insertion Procedure
Supporting the User
"Come Back Any Time": Reasons to Return
Helping Continuing Users
Removing the Intrauterine Device
Switching From an IUD to Another Method
Managing Any Problems
New Problems That May Require Switching Methods
Questions and Answers About the Intrauterine Device
Levonorgestrel Intrauterine Device
How Effective?
Side Effects, Health Benefits, Health Risks, and Complications
Who Can and Cannot Use 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
Explaining the Insertion Procedure
Supporting the User
"Come Back Any Time": Reasons to Return
Helping Continuing Users
Removing the Intrauterine Device
Switching From an IUD to Another Method
Managing Any Problems
New Problems That May Require Switching Methods
Questions and Answers About the LNG-IUD
Female Sterilization
How Effective?
Side Effects, Health Benefits, Health Risks, and Complications
Correcting Misunderstandings (see also Questions and Answers)
Who Can Have Female Sterilization
Medical Eligibility Criteria for Female Sterilization
Providing Female Sterilization
Ensuring Informed Choice
Performing the Sterilization Procedure
Local Anesthesia Is Best for Female Sterilization
Supporting the User
"Come Back Any Time": Reasons to Return
Helping Users
Managing Ectopic Pregnancy
Questions and Answers About Female Sterilization
Vasectomy
How Effective?
Side Effects, Health Benefits, Health Risks, and Complications
Correcting Misunderstandings (see also Questions and Answers)
Who Can Have a Vasectomy
Medical Eligibility Criteria for Vasectomy
Reaching the Vas: No-Scalpel Vasectomy
Vasectomy for Men With HIV
Providing Vasectomy
Ensuring Informed Choice
Performing the Vasectomy Procedure
Supporting the User
"Come Back Any Time": Reasons to Return
Helping Users
Questions and Answers About Vasectomy
Male Condoms
How Effective?
Side Effects, Health Benefits, and Health Risks
Bringing Up Condom Use
Correcting Misunderstandings (see also Questions and Answers)
Who Can and Cannot Use Male Condoms
Providing Male Condoms
Explaining How to Use
What Condom Users Should Not Do
Lubricants for Latex Condoms
Supporting the User
"Come Back Any Time": Reasons to Return
Helping Continuing Users
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 (see also Questions and Answers)
Who Can Use Female Condoms
Providing Female Condoms
Explaining How To Use
Supporting the User
Lubricants for Female Condoms
Tips for New Users
"Come Back Any Time": Reasons to Return
Helping Continuing Users
Questions and Answers About Female Condoms
Spermicides and Diaphragms
How Effective - Spermicides?
Side Effects, Health Benefits, and Health Risks - Spermicides
Correcting Misunderstandings - Spermicides (see also Questions and Answers)
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 (see also Questions and Answers)
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 for Users of Spermicides or the Diaphragm With Spermicide
Helping Continuing Users
New Problems That May Require Switching Methods
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 (see also Questions and Answers)
Who Can Use Calendar-Based Methods
Providing Calendar-Based Methods
Explaining How to Use Calendar-Based Methods
Calendar Rhythm Method
Who Can Use Symptoms-Based Methods
Providing Symptoms-Based Methods
Explaining How to Use Symptoms-Based Methods
Basal Body Temperature (BBT) Method
Ovulation Method
Symptothermal Method (basal body temperature + cervical secretions + other fertility signs)
Supporting the User
Helping Continuing Users
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 (see also Questions and Answers)
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 the User
How Can a Partner Help?
Helping Continuing Users
Questions and Answers About the Lactational Amenorrhea Method
Serving Diverse Groups
Adolescents
Provide Services with Care and Respect
All Contraceptives Are Safe for Young People
Men
Many Ways to Help Men
Women Near Menopause
Special Considerations About Method Choice
When a Woman Can Stop Using Family Planning
Relieving Symptoms of Menopause
Clients with Disabilities
Sexually Transmitted Infections, Including HIV
Who Is at Risk?
What Causes STIs?
Symptoms of Sexually Transmitted Infections
Common Vaginal Infections Often Confused With Sexually Transmitted Infections
Avoiding Sexually Transmitted Infections
Contraceptives for Clients with STIs, HIV, and AIDS
What Is Cervical Cancer?
Questions and Answers About Sexually Transmitted Infections, Including 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
Provide Important Information
When to Start Contraceptive Methods
Violence Against Women
What Can Providers Do?
Infertility
Preventing Infertility
Counseling Clients With Fertility Problems
Family Planning Provision
Successful Counseling
Who Provides Family Planning?
Family Planning Methods and Services Typically Offered by Various Types of Service Providers
Infection Prevention in the Clinic
Make Infection Prevention a Habit
Managing Contraceptive Supplies
Wall Chart Available
Family Planning for Adolescents and Women at High Risk for HIV
Who is at High Risk for Acquiring HIV?
What Family Planning Methods Can Be Used by Adolescents and Women at High Risk for HIV?
Providing HIV Testing and Prevention Services
Who Should Be Offered an HIV Test?
Talking about HIV Testing
HIV Testing Options
Preventing HIV Acquisition
Male Partner HIV Testing and Prevention Messages
Questions and Answers about Family Planning for Women at High Risk for HIV
Providing Family Planning Services During Public Health Emergencies
Maintaining Family Planning Services in an Epidemic
Safe Use of Contraceptive Methods in an Epidemic
Self-Care for Contraception
Use of Digital Health Technologies
Resources and WHO Guidance
Job Aids & Tools
Comparing Combined Methods
Comparing Injectables
Comparing Implants
Comparing Condoms
Comparing IUDs
If You Miss Pills
Female Anatomy
External Anatomy
The Menstrual Cycle
Male Anatomy
Correctly Using a Male Condom
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
APPENDIX
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
WHO Guidance Documents Used in Preparation of This Edition of the Handbook
Illustration and Photo Credits
Family Planning
A Global Handbook for Providers
Order
Job Aids & Tools
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