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Safety and Efficacy of

Contraceptive Methods
How To Hel p A Patient Choose?
SafeLy Lmcacy
ÞauenL Þreference
Sati sf acti on Wi th Contraceptive Methods
4.6 4.3 4.1 4.1 3.9 3.6 3.8
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WHO Medi cal El i gi bi l i ty Cri teri a (MEC)
o Lvldence based guldellnes for conLracepuve use
by Lhe World PealLh Crganlzauon (WPC) slnce
1996 updaLed regularly based on new evldence,
currenL 4
Lh
edluon
o 8ecommendauons for Lhe safe use of
conLracepuves among women and men
o Address crlLerla for Lhe lnluauon and conunued
use of all meLhods evaluaLed
MEC Categories
1 Can use the method No restrictions
2 Can use the method Advantages generally
outweigh theoretical or
proven risks
3 Should not use method
unless no other method
is appropriate
Theoretical or proven risks
generally outweigh
advantages
4 Should not use method Unacceptable health risk
Medlcal
condluons
8lrLh conLrol
meLhods
MLC CaLegory
United States MEC: 2010
o CurrenL WPC MLC conLalns > 1800
recommendauons
o no need Lo adapL mosL recommendauons
• Sclence ls Lhe same
• 8ecommendauons are used around Lhe world
o CuC accepLed ma[orlLy of WPC recommendauons
• AdapLed a few for Lhe uS conLexL
U. S. MEC for Contraceptive Use
U. S. MEC for Contraceptive Use
Contraceptive Ef ficacy
ÞerfecL use 1yplcal use
All users ln All Cycles
lrom Cllnlcal 1rlals - looklng only
aL Lhe monLhs when Lhe meLhod
was used correcLly and conslsLenLly
=
The Pear l Index
o number of pregnancles per 100 women uslng lL for one year
o lmpacLed by:
• 1he culLure and demographlcs of Lhe group belng sLudled
• 1he lnsLrucuon Lechnlque used Lo Leach Lhe meLhod
o llawed :
• Assumes a consLanL fallure raLe
• AcLually Lhe hlghesL fallure raLe ls Lhe ñrsL monLhs and Lhe ñrsL year
of use
• 1he longer Lhe durauon of Lhe sLudy Lhe lower Lhe Þearl lndex wlll be
Ef ficacy – Exampl es
ÞerfecL use 1yplcal use
o Condoms 2 13
o CCÞ 0.3 8
unproLecLed lnLercourse: 80 ln 100 women pregnanL ln a year
Natural Famil y Pl anning
ConLracepuve MeLhod
lallure 8aLe
ÞerfecL use 1yplcal use
no MeLhod 83° 83°
Þerlodlc Absunence
SLandard uays MeLhod
º
* 3° 12°
Cvulauon MeLhod 3° 22°
SympLoLhermal 2° 13-20°
1wo-uay MeLhod
º
3° 14°
* lncludlng Cycle 8eads
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Bar rier Methods
ConLracepuve MeLhod
lallure 8aLe
ÞerfecL use 1yplcal use
WlLhdrawal 4 ° 18 °
Condoms 2 ° 17 °
Cervlcal Cap (parous/nulllp) 26°/9° 32°/16°
Sponge (parous/nulllparous) 20°/9° 32°/16°
lemale Condoms 3 ° 27 °
ulaphragm 6 ° 16 °
9/&+'/. 6"'4"- 3"/.45 :4/&%&;%< 6+'4-/;"=&#" >";5'+.+(?
Hor monal Methods
ConLracepuve MeLhod
lallure 8aLe
ÞerfecL use 1yplcal use
Comblned Pormonal Þllls <1 ° 8 °
Þrogesun Cnly Þllls <1 ° 8 °
1ransdermal ÞaLch <1 ° 8 °
vaglnal 8lng <1 ° 8 °
3-MonLh ln[ecuon <1 ° 3 °
lmplanLs <1 ° <1 °
Copper luu/LnC luS <1 ° <1 °
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Cur rent Contraceptive Methods
MosL eñecuve

ÞrevenLs
pregnancy >99° of
Lhe ume

Male/lemale
SLerlllzauon
luu/luS
lmplanLs

very eñecuve

ÞrevenLs
pregnancy
~91-99° of Lhe
ume

Þllls
ln[ecLables
ÞaLch
8lng
ModeraLely
eñecuve

ÞrevenLs
pregnancy
~81-90° of Lhe
ume

Male/lemale
Condom
Sponge
ulaphragm
Lñecuve

ÞrevenLs
pregnancy up Lo
80° of Lhe ume

lerullLy awareness
Cervlcal cap
Spermlclde