Family Planning

Switching From an IUD to Another MethodThese guidelines ensure that the client is protected from pregnancywithout interruption when switching from a copper-bearing IUD or ahormonal IUD to another method. See also When to Start for each method.Switching toCombined oralcontraceptives(COCs),progestin-only pills(POPs),progestin-onlyinjectables,monthly injectables,combined patch,combined vaginalring, or implantsMale or femalecondoms,spermicides,diaphragms,cervical caps, orwithdrawalWhen to startóóóóIf starting during the first 7 days of monthlybleeding (first 5 days for COCs and POPs),start the hormonal method now and removethe IUD. No need for a backup method.If starting after the first 7 days of monthlybleeding (after the first 5 days for COCsand POPs) and she has had sex since her lastmonthly bleeding, start the hormonal methodnow. It is recommended that the IUD be keptin place until her next monthly bleeding.If starting after the first 7 days of monthlybleeding (after the first 5 days for COCs and POPs)and she has not had sex since her last monthlybleeding, the IUD can stay in place and beremoved during her next monthly bleeding, orthe IUD can be removed and she can use a backupmethod for the next 7 days (2 days for POPs).Immediately the next time she has sex after theIUD is removed.Fertility awarenessmethodsóImmediately after the IUD is removed.Female sterilizationóóIf starting during the first 7 days of monthlybleeding, remove the IUD and perform thefemale sterilization procedure. No need for abackup method.If starting after the first 7 days of monthlybleeding, perform the sterilization procedure.The IUD can be kept in place until her follow-upvisit or her next monthly bleeding. If a follow-upvisit is not possible, remove the IUD at the timeof sterilization. No need for a backup method.148 Family Planning: A Global Handbook for Providers