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Spotting between periods is a common side effect of IUDs, especially during the first few months after insertion.

It is not a sign of a complication and usually goes away over time.

Cramping in the lower abdomen is also a common side effect of IUDs, especially during and after insertion.

It is not a sign of a complication and can be relieved with over-the-counter pain medication.

Feeling some strings in the vagina is normal for IUD users.The strings are attached to the end of the IUD and allow the user and the provider to check that the IUD is in place.

The strings are not harmful and do not interfere with sexual activity.

Surgical methods are not reversible and cannot be undone if the client changes their mind.Surgical methods are permanent and require a qualified healthcare provider to perform the procedure

Surgical methods are not effective immediately and do require follow-up testing.

For example, after a vasectomy, a man needs to have semen analysis to confirm that there are no sperm in his semen.This may take several weeks or months after the surgery.Similarly, after a tubal ligation, a woman may need to have a hysterosalpingogram (HSG) to check that the fallopian tubes are completely blocked.

Surgical methods do not require general anesthesia and hospitalization.Most surgical methods can be done under local anesthesia and as outpatient procedures.However, some complications may arise that may require hospitalization, such as infection, bleeding, or injury to other organs.

The first 7 days of the menstrual cycle are not necessarily safe for avoiding pregnancy.Some women may have shorter cycles or irregular ovulation, which can make them fertile during this time.

The last 7 days of the menstrual cycle are also not necessarily safe for avoiding pregnancy.Some women may have longer cycles or irregular ovulation, which can make them fertile during this time.

The 14 days after the onset of the previous menstrual cycle are not a reliable indicator of fertility.The length of the menstrual cycle can vary from month to month, so counting from the previous cycle may not accurately reflect when ovulation occurs.

A client who has a regular menstrual cycle of 28 days can easily calculate their fertile days by subtracting 18 from the shortest cycle and 11 from the longest cycle.

In this case, both numbers are 10, so the fertile days are from day 10 to day 10 of the cycle.

A client who has a regular menstrual cycle of 30 days can also calculate their fertile days by subtracting 18 from the shortest cycle and 11 from the longest cycle.

In this case, both numbers are 12, so the fertile days are from day 12 to day 12 of the cycle.

A client who has an irregular menstrual cycle ranging from 27 to 33 days has a lower risk of unintended pregnancy than choice C because the cycle length variation is smaller.The fertile days for this client are from day 9 to day 22 of the cycle, calculated by subtracting 18 from the shortest cycle and 11 from the longest cycle.

Having a history of pelvic inflammatory disease does not affect the suitability of the SDM, as long as the woman has regular cycles.

Having a partner who travels frequently for work does not affect the suitability of the SDM, as long as the woman can track her cycle and avoid unprotected sex on her fertile days.

Having a history of endometriosis may cause irregular cycles, which makes the SDM less reliable