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October 10, 2006

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Population Reports: "When Contraceptives Change Monthly Bleeding"
INFO Reports: "Key Facts About the Menstrual Cycle"

Around the world many women find talking about monthly bleeding difficult. But the latest Population Reports issue concludes that informing and counseling women about potential, bothersome vaginal bleeding changes and how to manage them when using or considering hormonal contraceptives or IUDs is a big contribution to the successful use of these methods.

Family planning providers can take simple steps to help new clients decide whether or not to use a contraceptive that may change monthly bleeding; they can also help continuing clients prevent unwanted pregnancy effectively, according to the report from the INFO Project at the Johns Hopkins Bloomberg School of Public Health's Center for Communication Programs. "In fact, addressing bleeding changes may be the most important way that family planning providers can help users of these methods," write authors Ruwaida M. Salem and Vidya Setty.

Family planning providers can use the report to:

• Help explain possible bleeding changes to clients considering certain contraceptive methods.
• Help clients choose a family planning method with bleeding changes that they can accept, or else a method that does not change bleeding, if that is their preference.
• Offer practical advice and, when available, treatment to clients who experience bleeding changes due to their contraceptive method.
• Learn when bleeding changes might not be related to contraception and need referral for further investigation.
• Better understand the personal and social factors that affect women's views on menstruation so they can better counsel about bleeding changes due to contraceptives.

The 24-page report provides practical steps and explanations for the health provider to use, illustrated with easy-to-follow tools and diagrams that can be adapted for local use. For each contraceptive method that can cause bleeding changes, the report explains the type of bleeding change, how it can be managed or treated, how long it may last, and more.

Programs and organizations can use the report to:

• Learn creative approaches for educating girls and young women about menstruation and preparing them for the start of monthly bleeding.
• Work with parents and communities to increase understanding about menstruation and to help correct mistaken beliefs.

An 8-page INFO Reports issue entitled "Key Facts About the Menstrual Cycle," is provided as a companion tool to the Population Reports issue. Based on the latest evidence and international recommendations presented in the Population Reports issue, the report offers health care providers a quick reference to easy-to-understand answers to some of the most common questions about menstruation.

The INFO Reports issue is designed to complement existing reference guides and training materials on menstruation. It answers basic questions such as, "What is menstruation?," "Why does a woman have monthly bleeding?," "How long does monthly bleeding last?," and "Just what happens in the body during the menstrual cycle?"

The Report also discusses the menstrual cycle at different times of life — for adolescents, during pregnancy, during breastfeeding, and when women stop menstruating.

These reports were authored by Ruwaida M. Salem, MPH and Vidya Setty, MPH. R. Taylor Williamson, MPH, Hiliary Schwandt, MHS, and Faraz Naqvi provided research assistance.

To Find These Reports On Line:

The full-text version of this Population Reports issue, "When Contraceptives Change Monthly Bleeding: How Family Planning Providers and Programs Can Help Clients Choose and Use Suitable Methods" is available at http://www.infoforhealth.org/pr/j54/published/j54.pdf).

The full-text version of the INFO Reports companion issue, "Key Facts About the Menstrual Cycle," is available at http://www.infoforhealth.org/inforeports/menstruation/menstruation.pdf).

A PowerPoint presentation of the information in the Population Reports issue that can be adapted and used for training, classroom lectures, and other presentations is available for download at http://www.infoforhealth.org/pr/j54/published/j54presentation.ppt.

To order this latest Population Reports issue and the companion "Key Facts About the Menstrual Cycle" as well as other INFO publications in print, go to http://www.jhuccp.org/cgi-bin/orders/orderform.cgi. For a listing of all Population Reports issues online go to http://www.populationreports.org. Population Reports is published three times a year in English, French, and Spanish by the INFO Project at the Johns Hopkins Bloomberg School of Public Health's Center for Communication Programs.

INFO Reports feature a brief look at special topics, newsworthy events, and important new research and program developments in family planning and reproductive health. INFO Reports appear occasionally, as important topics arise. To view all issues of INFO Reports, visit http://www.infoforhealth.org/inforeports/index.shtml.

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