Menstrual Regulation in Family Planning Services

Menstrual regulation (MR) is the term applied to any treatment which is administered within 14 days of a missed menstrual period to ensure that a woman either is not pregnant or does not remain pregnant. Because pregnancy tests are not accurate at this stage of pregnancy, it cannot be reliably determined whether a woman is pregnant prior to the procedure. The most common method of treatment is vacuum aspiration using a small diameter, clear plastic, flexible cannula. Neither dilation of the cervix nor anesthesia is usually required.

Curetting the uterus for delayed periods has been performed for at least a century under the guise of “dry cupping”‘ or diagnostic endometrial biopsy to investigate amenorrhea. Many physicians have also had the experience of missing the ovum and having a pregnancy continue.

Unfortunately, because these procedures were performed under guises, their effectiveness and complication rates for use in women with amenorrhea are unknown. The first systematic studies of the practicability of menstrual regulation were initiated by the International Fertility Research Program2 in 1972. The efficacy, efficiency, safety, cost-effectiveness, and acceptability of menstrual regulation for fertility regulation must be considered before determining its place in family planning programs.

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