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.

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