Helping Continuing Users

Post-Insertion Follow-Up Visit (3 to 6 Weeks)

1. Ask how the client is doing with the method and whether she is satisfied. Ask if she has any questions or anything to discuss.

2. Ask especially if she is concerned about bleeding changes. Give her any information or help that she needs (see Managing Any Problems).

3. Ask her if she has:

• Increasing or severe abdominal pain or pain during sex or urination
• Unusual vaginal discharge
• Fever or chills
• Signs or symptoms of pregnancy (see common signs and symptoms)
• Not been able to feel strings (if she has checked them)
• Felt the hard plastic of an IUD that has partially come out

4. A routine pelvic examination at the follow-up visit is not required. It may be appropriate in some settings or for some clients, however. Conduct a pelvic examination particularly if the client’s answers lead you to suspect:

• A sexually transmitted infection or pelvic inflammatory disease
• The IUD has partially or completely come out

Any Visit

1. Ask how the client is doing with the method and about bleeding changes (see Post-Insertion Follow-Up Visit, Items 1 and 2).
2. Ask a long-term client if she has had any new health problems. Address problems as appropriate. See new health problems that may require switching methods.
3. Ask a long-term client about major life changes that may affect her needs—particularly plans for having children and STI/HIV risk. Follow up as needed.
4. Remind her how much longer the IUD will protect her from pregnancy.

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