Ask the client the questions below about known medical conditions. Examinations and tests are not necessary. If she answers “no” to all of the questions, then she can have implants inserted if she wants. If she answers “yes” to a question, follow the instructions; in some cases she can still start using implants.

1.    Do you have severe cirrhosis of the liver or a severe liver tumor?

NO   YES If the client reports severe cirrhosis or severe liver tumor, such as liver cancer, do not provide implants. Help her choose a method without hormones.

2.    Do you have a serious problem now with a blood clot in your leg or lungs?

NO   YES If the client reports a current blood clot in one of her legs (affecting deep veins, not superficial veins) or in a lung and she is not on anticoagulant therapy, do not provide implants. Help her choose a method without hormones.

3.    Are you having vaginal bleeding that is unusual for you?

NO   YES If the client has unexplained vaginal bleeding that suggests pregnancy or an underlying medical condition, implants could make diagnosis and monitoring of any treatment more difficult. Help her choose another method to use until the condition has been evaluated and treated, but not progestin-only injectables or a copper-bearing or hormonal IUD. After treatment, reconsider the use of implants.

4.    Do you have or have you ever had breast cancer?

NO   YES If yes, do not provide implants. Help her choose a method without hormones.

Also, a woman should not use implants if she reports having lupus with positive (or unknown) antiphospholipid antibodies and is not on immunosuppressive treatment. For complete classifications, see Appendix D – Medical Eligibility Criteria for Contraceptive Use. 

Be sure to explain the health benefits as well as the potential risks and side effects associated with the client’s chosen method. Also, point out any conditions that would make the method inadvisable for use by that particular client.