Reproductive steroids were used until the mid-1970s to rule out or confirm pregnancy. However in the advent of fast accurate pregnancy tests this practice has nearly disappeared. Researchers surveyed family planning (FP) providers in Ghana Kenya and Zambia from May to July 2000 to follow-up on anecdotal reports of the use of combined oral contraceptives to induce menses. Data collected in sub-Saharan Africa suggest that the practice of inducing menses to rule out pregnancy is still widespread. 13% of the Kenyan providers and 22% of the Ghanaian providers reported that they had induced menses in their clients in the previous 6 months. Use of this practice appears to be most common with postpartum FP clients whose lactational amenorrhea makes it difficult for providers to rule out pregnancy with certainty.