Chapter 18 Download Chapter

Providing Symptoms-Based Methods

When to Start

Once trained, a woman or couple usually can begin using symptoms-based methods at any time. Women not using a hormonal method can practice monitoring their fertility signs before they start using symptoms-based methods. Give clients who cannot start immediately another method to use until they can start.

Woman's situation When to start
Having regular menstrual cycles  Any time of the month

  • No need to wait until the start of next monthly bleeding.
No monthly bleeding
  • Delay symptoms-based methods until monthly bleeding returns.
After childbirth (whether or not breastfeeding)
  • She can start symptoms-based methods once normal secretions have returned.
  • Normal secretions will return later in breastfeeding women than in women who are not breastfeeding.
After miscarriage or abortion
  • She can start symptoms-based methods immediately with special counseling and support, if she has no infection-related secretions or bleeding due to injury to the genital tract.
Switching from a hormonal method
  • She can start symptoms-based methods in the next menstrual cycle after stopping a hormonal method.
After taking emergency contraceptive pills
  • She can start symptoms-based methods once normal secretions have returned.