2 Advantages generally outweigh theoretical or proven risks 3 Theoretical or proven risks usually outweigh the advantages



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Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Usehhs logocdc logo



Key:

1 No restriction (method can be used)



2 Advantages generally outweigh theoretical or proven risks



3

Theoretical or proven risks usually outweigh the advantages



4 Unacceptable health risk (method not to be used)




Updated June 2012. This summary sheet only contains a subset of the recommendations from the US MEC. For complete guidance, see: http://www.cdc.gov/reproductivehealth/unintendedpregnancy/USMEC.htm



Most contraceptive methods do not protect against sexually transmitted infections (STIs). Consistent and correct use of the male latex condom reduces the risk of STIs and HIV.





Condition

Sub-condition

Combined pill, patch, ring

Progestin-only pill

Injection

Implant

LNG--IUD

Copper-IUD








I

C

I

C

I

C

I

C

I

C

I

C

Age




Menarche to <40=1

Menarche to <18=1

Menarche to <18=2

Menarche to <18=1

Menarche to <20=2

Menarche to <20=2




>40=2

18-45=1

18-45=1

18-45=1

>20=1

>20=1




>45=1

>45=2

>45=1







Anatomic

abnormalities


a) Distorted uterine cavity













4

4

b) Other abnormalities













2

2

Anemias


a) Thalassemia

1

1

1

1

1

2

b) Sickle cell disease‡

2

1

1

1

1

2

c) Iron-deficiency anemia

1

1

1

1

1

2

Benign ovarian tumors


(including cysts)

1

1

1

1

1

1

Breast disease


a) Undiagnosed mass

2*

2*

2*

2*

2

1

b) Benign breast disease

1

1

1

1

1

1

c) Family history of cancer

1

1

1

1

1

1

d) Breast cancer‡



















i) current

4

4

4

4

4

1

ii) past and no evidence of current disease for 5 years

3

3

3

3

3

1

Breastfeeding

(see also Postpartum)


a) < 1 month postpartum

3*

2*

2*

2*







b) 1 month or more postpartum

2*

1*

1*

1*






Cervical cancer


Awaiting treatment

2

1

2

2

4

2

4

2

Cervical ectropion





1

1

1

1

1

1

Cervical intraepithelial neoplasia





2

1

2

2

2

1

Cirrhosis


a) Mild (compensated)

1

1

1

1

1

1

b) Severe‡ (decompensated)

4

3

3

3

3

1

Deep venous thrombosis

(DVT) /Pulmonary

embolism (PE)


a) History of DVT/PE, not on anticoagulant therapy



















i) higher risk for recurrent DVT/PE

4

2

2

2

2

1

ii) lower risk for recurrent DVT/PE

3

2

2

2

2

1

b) Acute DVT/PE

4

2

2

2

2

2

c) DVT/PE and established on anticoagulant therapy for at least 3 months



















i) higher risk for recurrent DVT/PE

4*

2

2

2

2

2

ii) lower risk for recurrent DVT/PE

3*

2

2

2

2

2

d) Family history (first-degree relatives)

2

1

1

1

1

1

e) Major surgery



















(i) with prolonged immobilization

4

2

2

2

2

1

(ii) without prolonged immobilization

2

1

1

1

1

1

f) Minor surgery without immobilization

1

1

1

1

1

1

Depressive disorders





1*

1*

1*

1*

1*

1*

Diabetes mellitus (DM)


a) History of gestational DM only

1

1

1

1

1

1

b) Non-vascular disease


















Diabetes mellitus (cont.)


(i) non-insulin dependent

2

2

2

2

2

1

(ii) insulin dependent‡

2

2

2

2

2

1

c) Nephropathy/ retinopathy/ neuropathy‡

3/4*

2

3

2

2

1

d) Other vascular disease or diabetes of >20 years' duration‡

3/4*

2

3

2

2

1

Endometrial cancer‡





1

1

1

1

4

2

4

2

Endometrial hyperplasia





1

1

1

1

1

1

Endometriosis





1

1

1

1

1

2

Epilepsy‡


(see also Drug Interactions)

1*

1*

1*

1*

1

1

Gallbladder

disease


a) Symptomatic



















(i) treated by cholecystectomy

2

2

2

2

2

1

(ii) medically treated

3

2

2

2

2

1

(iii) current

3

2

2

2

2

1

b) Asymptomatic

2

2

2

2

2

1

Gestational trophoblastic

disease


a) Decreasing or

undetectable ß-hCG levels



1

1

1

1

3

3


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