Family Health Intl- Quick reference chart for the WHO Medical Eligibility Criteria for Contraceptive Use

Publication date: 2006

CONDITION COC DMPA/NET-EN CU-IUD Age Menarche to 39 years 40 years or more Menarche to 17 years 18 years to 45 years More than 45 years Menarche to 19 years 20 years or more Nulliparous Breastfeeding Less than 6 weeks postpartum * 6 weeks to 6 months postpartum 6 months postpartum or more Smoking Age < 35 years Age ≥ 35 years, < 15 cigarettes/day Age ≥ 35 years, ≥ 15 cigarettes/day Hypertension History of hypertension where blood pressure: CANNOT be evaluated Is controlled and CAN be evaluated Systolic 140 - 159 or diastolic 90 - 99 Systolic ≥ 160 or diastolic ≥ 100 Headaches Non-migrainous (mild or severe) I C Migraine without aura (age < 35 years) I C I C Migraine without aura (age ≥ 35 years) I C I C Migraines with aura I C History of deep venous thrombosis Superficial thrombophlebitis Complicated valvular heart disease Ischemic heart disease/stroke Diabetes Non-vascular disease Vascular disease or diabetes of > 20 years Malaria Non-pelvic tuberculosis Thyroid disease Iron deficiency anemia Sickle cell anemia CONDITION COC DMPA/NET-EN CU-IUD Known hyperlipidemias Cancers Cervical I C Endometrial I C Ovarian I C Cervical ectropion Breast disease Undiagnosed mass ** ** Family history of cancer Current cancer Uterine fibroids without cavity distortion Endometriosis Trophoblast disease (malignant gestational) Vaginal bleeding patterns Irregular without heavy bleeding Heavy or prolonged, regular and irregular Unexplained bleeding I C Cirrhosis Mild Severe Current symptomatic gall bladder disease Cholestasis Related to the pregnancy Related to oral contraceptives Hepatitis Active Client is a carrier Liver tumors STIs/PID Current purulent cervicitis, chlamydia, gonorrhea I C Vaginitis Current pelvic inflammatory disease (PID) I C Other STIs (excluding HIV/hepatitis) Increased risk of STIs Very high individual risk of exposure to STIs I C HIV High risk of HIV or HIV-infected AIDS No antiretroviral therapy (ARV) I C Not clinically well on ARV therapy I C Clinically well on ARV therapy Use of: Griseofulvin Rifampicin Other antibiotics Quick Reference Chart for the WHO Medical Eligibility Criteria for Contraceptive Use – to initiate or continue use of combined oral contraceptives (COCs), depot-medroxyprogesterone acetate (DMPA), norethisterone enantate (NET-EN), copper intrauterine device (Cu-IUD) I/C (Initiation/Continuation): A woman may fall into either one category or another, depending on whether she is initiating or continuing to use a method. For example, a client with current PID who wants to initiate IUD use would be considered as Category 4, and should not have an IUD inserted. However, if she develops PID while using the IUD, she would be considered as Category 2. This means she could generally continue using the IUD and be treated for PID with the IUD in place. Where I/C is not marked, a woman with that condition falls in the category indicated – whether or not she is initiating or continuing use of the method. * Breastfeeding does not affect initiation and use of the IUD. Regardless of breastfeeding status, postpartum insertion of the IUD is Category 2 up to 48 hours postpartum, Category 3 from 48 hours to four weeks, and Category 1 four weeks and after. ** Evaluation should be pursued as soon as possible. Category 1 There are no restrictions for use. Category 2 Generally use; some follow-up may be needed. Category 3 Usually not recommended; clinical judgment and continuing access to clinical services are required for use. Category 4 The method should not be used. So ur ce : A da pt ed fr om M ed ic al E lig ib ili ty C rit er ia fo r C on tr ac ep tiv e U se . G en ev a: W or ld H ea lth O rg an iz at io n. T hi rd e di tio n, 2 00 4. Av ai la bl e: h tt p: // w w w .w ho .in t/ re pr od uc tiv e- he al th /p ub lic at io ns /M EC / © 10/2006

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