Ask the client the questions below about known medical conditions. Examinations and tests are not necessary. If she answers "no" to all of the questions, then she can have implants inserted if she wants. If she answers "yes" to a question, follow the instructions. In some cases she can still start using implants.

1.    Do you have severe cirrhosis of the liver or a severe liver tumor?

NO   YES If she reports severe cirrhosis or severe liver tumor, such as liver cancer, do not provide implants. Help her choose a method without hormones.

2.    Do you have a serious problem now with a blood clot in your leg or lungs?

NO   YES If she reports a current blood clot in legs (affecting deep veins, not superficial veins) or in a lung and she is not on anticoagulant therapy, do not provide implants. Help her choose a method without hormones.

3.    Do you have vaginal bleeding that is unusual for you?

NO   YES If she has unexplained vaginal bleeding that suggests pregnancy or an underlying medical condition, implants could make diagnosis and monitoring of any treatment more difficult. Help her choose a method to use until the condition is evaluated (not progestin-only injectables or a copper-bearing or LNG-IUD). After treatment, reconsider the use of implants.

4.    Do you have or have you ever had breast cancer?

NO   YES Do not provide implants. Help her choose a method without hormones.

Also, women should not use implants if they report having lupus with positive (or unknown) antiphospholipid antibodies and are not on immunosuppressive treatment. For complete classifications, see Medical Eligibility Criteria for Contraceptive Use. 

Be sure to explain the health benefits and risks and the side effects of the method that the client will use. Also, point out any conditions that would make the method inadvisable, when relevant to the client.