Tell Clients About Family Planning Methods
Clients need to know about family planning methods before choosing one. Here is basic information about 9 methods. You can mention all available methods, but tell clients most about the methods that interest them. (Remember that clients may already know something about some methods.) Then, with the checklists on the yellow chart, you can help your clients choose a method. Note: Most methods do not protect against sexually transmitted diseases (STDs), including HIV/AIDS. During sex, condoms are the best protection against STDs.
HOW IT WORKS	ADVANTAGES	DISADVANTAGES
Low-Dose Combined Oral Contraceptives (The Pill)
When a woman swallows a pill each day, her ovaries stop releasing eggs. She cannot become pregnant without an egg. Effectiveness: Very effective if taken every day. Effective as usually used.* No STD protection. Also can be used for emergency contraception. See Emergency Oral Contraception.	No need to do anything at the time of sex. Monthly periods are regular, light, short; milder, fewer cramps. Help prevent iron deficiency anemia, ectopic pregnancy, ovarian and uterine cancer, and pelvic inflammatory disease (PID).	Some women have upset stomach (especially in first 3 months) and/or spotting or bleeding between menstrual periods, missed periods, mild headaches, breast tenderness, and/or slight weight gain. Some women cannot remember a pill every day. In rare cases the Pill causes stroke, heart attack, or blood clots deep in the leg, especially in women with high blood pressure and in women who smoke and also are 35 or older.
Condom
A very thin, flexible sheath that covers the man's erect penis during sex. It keeps sperm out of the woman's vagina. Also prevents many STDs from passing between sex partners. Effectiveness: Effective if used correctly and every time. Only somewhat effective as usually used.* Best Method for STD prevention.	Only method proved to prevent STDs, including HIV/AIDS, and also pregnancy when used correctly with every act of sexual intercourse. Helps prevent conditions caused by STDs, such as pelvic inflammatory disease (PID) in women and infertility in both women and men. No need to see a health care provider before using.	Must take the time to put condom on erect penis before sex. May decrease sensation. May cause itching for a few people allergic to latex rubber.
Female Sterilization
A specially trained health care provider makes a small surgical opening in the woman's abdomen and closes off both tubes that carry eggs from the ovaries to the womb. Then eggs cannot meet the man's sperm. The woman still has menstrual periods. Effectiveness: Very effective and permanent.* No STD protection.	A single procedure leads to effective, lifelong family planning. Nothing to remember and no repeated clinic visits needed. No known long-term side effects or health risks. A woman can still have sex as usual.	Usually painful for a few days after the procedure. Slight chance of infection or bleeding at incision, internal infection or bleeding, or injury to internal organs. Usually not reversible.
Vasectomy
A specially trained health care provider makes a small surgical opening in the man's scrotum (the sac of skin that holds the testes) and closes off both tubes that carry sperm from his testes. The man still produces semen, but it has no sperm in it to make a woman pregnant. Effectiveness: Very effective and permanent.* No STD protection.	A single, quick procedure leads to effective, lifelong family planning. A man can still ejaculate and have sex as usual. No known long-term side-effects or health risks.	Not effective at once. Couple must use another method for at least the first 20 ejaculations or 3 months. Usually some discomfort for a few days after the procedure. Possibly also some pain, swelling, and bruising in the scrotum. Usually not reversible.
Long-Acting Injectable Contraceptives
Injectables Depo-Provera (DMPA) and Noristerat (NET EN) stop ovaries from releasing eggs. A woman cannot become pregnant without an egg. They also thicken cervical mucus so sperm cannot pass. Effectiveness: Very effective when spaced 3 months apart (for DMPA) or 2 months apart (for NET EN).* No STD protection.	Private. No one else can tell that the woman is using contraception. Long-term yet reversible. Each injection lasts at least 3 months (DMPA) or 2 months (NET EN). The woman has to remember only to return for her next injection.	Changes in menstrual bleeding are normal—such as light spotting at first and no periods after the first year of use. (Some women consider no periods an advantage.) Some women gain some weight. (Some women consider this an advantage.) If stopping to become pregnant, average 4 months longer wait before pregnancy than after other methods.
Norplant Implants
Small plastic capsules placed under the skin of a woman's arm slowly release a hormone. The hormone thickens cervical mucus so sperm cannot pass. Sometimes also stop ovaries from releasing eggs. Effectiveness: Very effective.* No STD protection.	Lasts at least 5 years; fertility returns when capsules are taken out. Nothing to remember. No need to do anything at time of sex. Helps prevent iron deficiency anemia and ectopic pregnancy.	Changes in menstrual bleeding are normal—especially spotting or bleeding between periods. Some women have no periods. (Some women consider no periods an advantage.) Clinic procedure needed to start or stop use.
Intrauterine Device (IUD)
A small, flexible plastic frame, often with copper wire or sleeves on it. A health care provider inserts the IUD into the woman's womb through her vagina. The IUD stops egg and sperm from meeting. Effectiveness: Very effective.* No STD protection.	Effective prevention of pregnancy for as long as 10 years, fertility returns when IUD is taken out. No need to do anything at the time of sex. Can be inserted just after childbirth.	Many women at first have longer, heavier menstrual periods, bleeding or spotting between periods, or more menstrual cramps or pain. Clinic procedure needed to start or stop use. Pelvic inflammatory disease is more likely to follow STD infection if a woman is using an IUD.
Fertility Awareness-Based Methods Including Periodic Abstinence
A woman learns to recognize the fertile time of her menstrual cycle. To prevent pregnancy, a couple avoids vaginal sex during the fertile time or else uses a barrier method or withdrawal. Effectiveness: Effective if used correctly. Only somewhat effective as usually used.* No STD protection.	No physical side effects. Very little or no cost. Most couples can use these methods if committed to them. Acceptable to some religious groups that object to other methods.	More effective methods take 2 or 3 months to learn. Calendar method takes 6 months of recording cycle length before it can be used. Long abstinence may cause tension. Some methods may be less reliable or difficult to use if woman is sick, has a vaginal infection, or is breastfeeding.
Vaginal Methods (Spermicides, Diaphragm, Cervical Cap)
A woman places a spermicide, or else a diaphragm or cap with spermicide, in her vagina before sex. Spermicides kill sperm or stop their movement. Diaphragms and caps keep sperm out of the womb. Effectiveness: Effective when used correctly and every time. Only somewhat effective as usually used.* Help prevent STDs.	Woman-controlled method for use when needed. May help prevent some STDs and conditions caused by STDs. Possibly some protection against HIV/AIDS, but this is not proved. No need to see a health care provider before using spermicides.	May cause irritation. Can make urinary tract infections more common. Woman must put method in vagina before every act of sexual intercourse.

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