Treatment of vaginal bleeding irregularities induced by progestin-only contraceptives
RHL practical aspects by Brache V
FIRST CONTACT (PRIMARY CARE) LEVEL
At this level, if combined estrogen–progestin contraceptive pills are available and are prescribed for contraception, they could be also prescribed for the treatment of prolonged bleeding in users of progestin-only contraceptive implants. Often at the primary care level there are no facilities for insertion and removal of contraceptive implants. Thus, being able to offer some treatment for women who are troubled by prolonged bleeding from a contraceptive implant may be particularly important at this level.
REFERRAL HOSPITAL (SECONDARY CARE) LEVEL
The secondary level of care will be needed in cases when the treatment is unsuccessful or the problem repeats several times, as many women will prefer to remove the implants or move to another method in case of users of long acting injectables and progestin-only pills.
AT HOME OR IN THE COMMUNITY
Women who fulfill the conditions to be eligible for community distribution of pills can be treated at this level with combined estrogen–progestin contraceptives.
Acknowledgements: The author is grateful to Dr. Anibal Faundes, CEMICAMP, Campinas, Brazil, for his wise input and comments.
This document should be cited as: Brache V. Treatment of vaginal bleeding irregularities induced by progestin-only contraceptives: RHL practical aspects (last revised: 11 September 2007). The WHO Reproductive Health Library; Geneva: World Health Organization.