APPENDIX B - Signs and Symptoms of Serious Health Conditions

The table below lists signs and symptoms of some serious health conditions. These conditions are mentioned under Health Risks or Managing Any Problems in the chapters on contraceptive methods. These conditions occur rarely to extremely rarely among users of the method. They also occur rarely among people of reproductive age generally. Still, it is important to recognize possible signs of these conditions and to take action or refer for care if a client reports them. In some cases, clients who develop one of these conditions may need to choose another contraceptive method.

Condition Description Signs and Symptoms
Deep vein thrombosis A blood clot that develops in the deep veins of the body, generally in the legs Persistent, severe pain in one leg, sometimes with swelling or red skin.
Ectopic pregnancy Pregnancy in which the fertilized egg implants in tissue outside the uterus, most commonly in a fallopian tube but sometimes in the cervix or abdominal cavity In the early stages of ectopic pregnancy, symptoms may be absent or mild, but eventually they become severe. A combination of these signs and symptoms should increase suspicion of ectopic pregnancy:

  • Unusual abdominal pain or tenderness
  • Abnormal vaginal bleeding or no monthly bleeding—especially if a change from her usual bleeding pattern
  • Light-headedness or dizziness
  • Fainting
Heart attack Occurs when the blood supply to the heart is blocked, usually due to a build-up of cholesterol and other substances in the coronary arteries Chest discomfort or uncomfortable pressure; fullness, squeezing, or pain in the center of the chest that lasts longer than a few minutes or that comes and goes; spreading pain or numbness in one or both arms, back, jaw, or stomach; shortness of breath; cold sweats; nausea.
Liver disorders Infection with hepatitis inflames the liver; cirrhosis scars tissue, which blocks blood flow through the liver Yellow eyes or skin (jaundice) and abdominal swelling, tenderness, or pain, especially in the upper abdomen.
Pelvic inflammatory disease (PID) An infection of the upper genital tract, caused by various types of bacteria Lower abdominal pain; pain during sex, pelvic examination, or urination; abnormal vaginal bleeding or discharge; fever; cervix bleeds when touched. In a pelvic examination, signs of PID include tenderness in the ovaries or fallopian tubes, yellowish cervical discharge containing mucus and pus, bleeding easily when the cervix is touched with a swab, or a positive swab test, and tenderness or pain when moving the cervix and uterus during pelvic examination.
Pulmonary embolism A blood clot that travels through the bloodstream to the lungs Sudden shortness of breath, that may worsen with a deep breath, cough that may bring up blood, fast heart rate, and a light-headed feeling.
Ruptured ectopic pregnancy When a fallopian tube breaks due to an ectopic pregnancy Sudden sharp or stabbing pain in lower abdomen, sometimes on one side. Possible right shoulder pain. Usually, within hours the abdomen becomes rigid and the woman goes into shock.
Severe allergic reaction to latex When a person's body has a strong reaction to contact with latex Rash over much of the body, dizziness brought on by a sudden drop in blood pressure, difficult breathing, loss of consciousness (anaphylactic shock).
Stroke When arteries to the brain become blocked or burst, preventing normal blood flow and leading to the death of brain tissue Numbness or weakness of the face, arm or leg, especially on one side of the body; confusion or trouble speaking or understanding; trouble seeing in one or both eyes; trouble walking, dizziness, loss of balance or coordination; severe headache with no other known cause. Signs and symptoms develop suddenly.
Toxic shock syndrome A severe reaction throughout the body to toxins released by bacteria High fever, body rash, vomiting, diarrhea, dizziness, muscle aches. Signs and symptoms develop suddenly.
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