Who Can Use Symptoms-Based Methods

Medical Eligibility Criteria for
Symptoms-Based Methods

All women can use symptoms-based methods. No medical conditions prevent the use of these methods, but some conditions can make them harder to use effectively.

Caution means that additional or special counseling may be needed to ensure correct use of the method.

Delay means that use of a particular fertility awareness method should be delayed until the condition is evaluated or corrected. Give the client another method to use until she can start the symptoms-based method.

In the following situations use caution with symptoms-based methods:

• Recently had an abortion or miscarriage
• Menstrual cycles have just started or have become less frequent or stopped due to older age (Menstrual cycle irregularities are common in young women in the first several years after their first monthly bleeding and in older women who are approaching menopause. Identifying the fertile time may be difficult.)
• A chronic condition that raises her body temperature (for basal body temperature and symptothermal methods)

In the following situations delay starting symptoms-based methods:

• Recently gave birth or is breastfeeding (Delay until normal secretions have returned—usually at least 6 months after childbirth for breastfeeding women and at least 4 weeks after childbirth for women who are not breastfeeding. For several months after regular cycles have returned, use with caution.)
• An acute condition that raises her body temperature (for basal body temperature and symptothermal methods)
• Irregular vaginal bleeding
• Abnormal vaginal discharge

In the following situations delay or use caution with symptoms-based methods:

• Taking any mood-altering drugs such as anti-anxiety therapies (except benzodiazepines), antidepressants (selective serotonin reuptake inhibitors [SSRIs], tricyclic, or tetracyclic), anti-psychotics (including chlorpromazine, thioridazine, haloperidol, risperdone, clozapine, or lithium), long-term use of certain antibiotics, any nonsteroidal anti-inflammatory drug (such as aspirin, ibuprofen, or paracetamol), or antihistamines. These drugs may affect cervical secretions, raise body temperature, or delay ovulation.