Summary of initial consultation

Box 6: Summary of POI initial consultation

Discuss all contraception options
Medical eligibility

Avoid if:

  • History of breast cancer
Caution if:
  • History of CVD/PVD/multiple risk factors
  • Severe liver disease
  • Risk of osteoporosis
  • Keen to start a family soon
Discuss possible side effects
  • Altered bleeding
  • Weight gain
  • Delay in return to fertility
  • ·Lowers bone density
Examinations needed

BMI

Consider if appropriate:

  • Cervical smear
  • BP screen
Extra precautions needed
  • If starting within 5 days of cycle none needed
  • After 5 days, extra precautions for 7 days
  • If switching from non-DSG POP, CHC or IUC, extra precautions for 7 days*
Inject & document
  • Usually gluteal, though consider deltoid in larger women
  • Document site, batch number and expiry date
Follow-up
  • Give follow-up date before woman leaves
  • Every 13 weeks
  • Over 14 weeks, only given if definitely not pregnant

  *As mentioned above, up to day 5 only applies to true cycles.  These rules do not apply for women on CHC.  For women on CHC, 7 days extra precautions are needed if started from day 3 of HFI and during first week of taking CHC.  If POI delivered week 2 or 3 then no extra precautions needed.   

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Contraception

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