How to Use the ASA Cycle

Addressing Concerns:

Example: “My mom said it’s not healthy not to get my period.”

Affirm/Acknowledge

“Your mother is completely right. When you are not using contraception that has hormones in it, it is important to get your period” (Agreement)

Share Content/Information

Interestingly, when someone is using a method with hormones it keeps the lining of the uterus very thin and so you don’t need to get a regular period to keep the uterus healthy. (Show a diagram of a uterus).

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Knowing that, how would it be for you to not get periods?

Addressing Side Effects:

Example: “I’ve been having super heavy periods since I had the copper IUD put in and it’s been hard to deal with.”

Affirm/Acknowledge

“Wow, what a drag. (Empathy) Anyone would find that hard to deal with.” (Validation)

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“There are medications like the ones a lot of people use for headaches that can lessen the amount of bleeding by half.”

Ask a Question

“Would you like to hear more about that?”

Responding to Concerns:

Example: "I don't want to go on birth control because I really want to have kids someday and I read online that birth control can mess with that."

Affirm/Acknowledge

“I hear that from my patients a lot! (Validation) Going online to find information can be really helpful. (Positive Feedback) You're right that with one of the methods, the shot, fertility can take a while to go back to normal” (Agreement)

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“With all of the other methods your ability to get pregnant will go back to whatever is normal for you immediately after you stop using it."

Ask a Question

“What thoughts do you have about any of those other methods?”

Responding to Removal Requests: (Part 1)

Example: “I want to take out my implant today.”

Affirm/Acknowledge

“I understand that you would like your IUD/Implant removed.”

(Agreement)

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“I will absolutely do that today”/ “I will absolutely get you scheduled with a provider that does the procedure.” (for staff or provider who do not place/remove IUDs/implants)

Ask a Question

“Might I ask, what makes you want to remove your IUD/implant?”

Responding to Removal Requests:
(Part 2)

Example: “I’m really frustrated that I’ve been on my period nonstop for the last 6 weeks.”

Affirm/Acknowledge

“6 weeks. No wonder you feel frustrated.”

(Empathy)

Share Content/Information

“I don’t know if anyone has talked to you about this before, but there are medications that can help with that.”

Ask a Question

“Would you like to hear more about those options before we start getting ready to take this out today?”

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