Implants: Tools for Providers
October 2007 Issue No. 15	The INFO Project • Johns Hopkins Bloomberg School of Public Health • Center for Communication Programs • 111 Market Place, Suite 310 • Baltimore, Maryland 21202, USA • 410-659-6300 • 410-659-6266 (fax) • www.infoforhealth.org • infoproject@jhuccp.org

Counseling Clients About Implants Medical Eligibility Criteria Checklist for Implants Checklist: Providing Implants, With Appropriate Infection Prevention Practices Tool: Counseling About Changes in Monthly Bleeding Insertion and Removal of the New Implants Questions and Answers About Implants Tool: Implant Reminder Card Sources Subscription and Ordering Information How to Use This Report Credits

Medical Eligibility Criteria Checklist for Implants

Ask the client the questions below about known medical conditions. Examinations and tests are not necessary. If she answers “no” to all of the questions, then she can have implants inserted if she wants. If she answers “yes” to a question, follow the instructions. In some cases she can still start using implants. Be sure to explain the health benefits and risks and the side effects of implants. Also, point out any conditions that would make using implants inadvisable, when relevant to the client.

1. Are you breastfeeding a baby less than 6 weeks old?
NO YES She can start using implants as soon as 6 weeks after childbirth.

2. Do you have severe cirrhosis of the liver, a liver infection, or liver tumor? (Are her eyes or skin unusually yellow? [signs of jaundice])
NO YES If she reports serious active liver disease (jaundice, active hepatitis, severe cirrhosis, liver tumor), do not provide implants. Help her choose a method without hormones.

3. Do you have a serious problem now with a blood clot in your legs or lungs?
NO YES If she reports a current blood clot (not superficial clots), do not provide implants. Help her choose a method without hormones.

4. Do you have vaginal bleeding that is unusual for you?
NO YES If she has unexplained vaginal bleeding that suggests pregnancy or an underlying medical condition, implants could make diagnosis and monitoring of any treatment more difficult. Help her choose a method to use while being evaluated and treated (not progestin-only injectables, or a copper-bearing or hormonal IUD). After evaluation and possible treatment, re-evaluate for use of implants.

5. Are you taking medication for seizures? Are you taking rifampicin for tuberculosis or other illness?
NO YES If she is taking barbiturates, carbamazepine, oxcarbazepine, phenytoin, primidone, topiramate, or rifampicin, do not provide implants. These medications can make implants less effective. Help her choose another method but not combined oral contraceptives or progestin-only pills.

6. Do you have or have you ever had breast cancer?
NO YES Do not provide implants. Help her choose a method without hormones.

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