Provide information and counseling on MH, including information about the full range of available options for managing menstrual (and contraceptive-induced) bleeding and pain, including information on self-care options and if feasible, access to, or at least information on where to access, commercial menstrual products locally, using tools such as Managing Menstruation: Know Your Options.11 Recognize that FP users may need more, less, or different MH products when they are using contraception and that this can change over time.
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Provide access to comprehensive youth-responsive services30 that include MH education and information about the full range of MH and FP, including self-care options, to ensure smooth transition into puberty and to ensure that future MH and FP needs are met as soon as they arise. Ensure that services are age-appropriate and welcome all genders.
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| Provide information on FP, including on the full contraceptive method mix including complete and correct information about fertility-based awareness methods and lactation amenorrhea method options.b If the client chooses to use FP, provide effective, evidence-based counseling during and after method selection about potential contraceptive-induced menstrual changes, using provider job aids such as the NORMAL tool.34
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| Provide adequate support and clinical treatment for undesirable contraceptive-induced menstrual changes. Ensure adequate follow-up services and counsel FP users that they can return at any time if they have questions or concerns.
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| Provide effective, evidence-based postpartum counseling including products for the management of postpartum bleeding, information about the return of menstruation and fertility after pregnancy and after FP use, as well as support on tapering off FP when trying to conceive.
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| Promote use of the pregnancy checklist41 and/or provide access to low-cost pregnancy tests to ensure same-day provision of contraceptive methods among women seeking services when they are not menstruating (i.e., to ensure providers do not rely on the presence of menses as an indicator that a client is not pregnant before providing contraceptive methods.)
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| | | Provide information and services related to perimenopause and menopause, including how to manage symptoms and counsel on contraceptive use during this life stage. Also, ensure perimenopausal people have access to low-dose contraceptives as an option to relieve menopause symptoms.
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Ask about and address concerns about menstruation and menstrual discomfort, including diagnosis and treatment of disorders. Even in the absence of a diagnosis, provide information on management of symptoms, which should include education on self-care (light exercise, stretching and/or yoga, applying heat such as a hot water bottle, taking ibuprofen or naproxen, and other evidence-based self-care options), contraception, and other available options.
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