You are on page 1of 2

Summary Chart of U.S.

Medical Eligibility Criteria for Contraceptive Use, 2010


Key: This summary sheet only contains a subset of the recommendations from the US MEC. For complete guidance, see:
1 No restriction (method can be used) www.cdc.gov/reproductivehealth/usmec
2 Advantages generally outweigh theoretical or proven risks
3 Theoretical or proven risks usually outweigh the advantages Most contraceptive methods do not protect against sexually transmitted infections (STIs). Consistent and correct use of the male latex
4 Unacceptable health risk (method not to be used) condom reduces the risk of STIs and HIV.

Progestin-only pill
Progestin-only pill

Combined pill,
Sub-condition
Combined pill,
Sub-condition

Copper-IUD
Copper-IUD

patch, ring

LNG--IUD
patch, ring

Condition
LNG--IUD
Condition

Injection
Injection

Implant
Implant
I C I C I C I C I C I C I C I C I C I C I C I C
Age Menarche Menarche Menarche Menarche Menarche Menarche DM (cont.) b) Non-vascular disease
to <40=1 to <18=1 to <18=2 to <18=1 to <20=2 to <20=2 (i) non-insulin dependent 2 2 2 2 2 1
>40=2 18-45=1 18-45=1 18-45=1 >20=1 >20=1 (ii) insulin dependent‡ 2 2 2 2 2 1
>45=1 >45=2 >45=1 c) Nephropathy/ retinopathy/ 3/4* 2 3 2 2 1
Anatomic a) Distorted uterine cavity 4 4 neuropathy‡
abnormalities b) Other abnormalities 2 2 d) Other vascular disease or 3/4* 2 3 2 2 1
Anemias a) Thalassemia 1 1 1 1 1 2 diabetes of >20 years' duration‡
b) Sickle cell disease‡ 2 1 1 1 1 2 Endometrial 1 1 1 1 4 2 4 2
c) Iron-deficiency anemia 1 1 1 1 1 2 cancer‡
Benign ovarian (including cysts) 1 1 1 1 1 1 Endometrial 1 1 1 1 1 1
tumors hyperplasia
Breast disease a) Undiagnosed mass 2* 2* 2* 2* 2 1 Endometriosis 1 1 1 1 1 2
b) Benign breast disease 1 1 1 1 1 1 Epilepsyठsee drug interactions 1* 1* 1* 1* 1 1
c) Family history of cancer 1 1 1 1 1 1 Gall-bladder a) Symptomatic
d) Breast cancer‡ disease (i) treated by 2 2 2 2 2 1
i) current 4 4 4 4 4 1 cholecystectomy
ii) past and no evidence of 3 3 3 3 3 1 (ii) medically treated 3 2 2 2 2 1
current disease for 5 years (iii) current 3 2 2 2 2 1
Breastfeeding a) < 1 month postpartum 3* 2* 2* 2* b) Asymptomatic 2 2 2 2 2 1
b) 1 month or more postpartum 2* 1* 1* 1* Gestational a) Decreasing or 1 1 1 1 3 3
Cervical cancer Awaiting treatment 2 1 2 2 4 2 4 2 trophoblastic undetectable ß-hCG levels
Cervical 1 1 1 1 1 1 disease b) Persistently elevated 1 1 1 1 4 4
ectropion ß-hCG levels or
Cervical 2 1 2 2 2 1 malignant disease‡
intraepithelial
Headaches a) Non-migrainous 1* 2* 1* 1* 1* 1* 1* 1* 1* 1* 1*
neoplasia (CIN)
Cirrhosis a) Mild (compensated) b) Migraine
1 1 1 1 1 1
b) Severe‡ (decompensated) i) without aura, age <35 2* 3* 1* 2* 2* 2* 2* 2* 2* 2* 1*
4 3 3 3 3 1
Deep venous a) History of DVT/PE, not on ii) without aura, age >35 3* 4* 1* 2* 2* 2* 2* 2* 2* 2* 1*
thrombosis anticoagulant therapy iii) with aura, any age 4* 4* 2* 3* 2* 3* 2* 3* 2* 3* 1*
(DVT) i) higher risk for recurrent 4 2 2 2 2 1 History of a) Restrictive procedures 1 1 1 1 1 1
/Pulmonary DVT/PE bariatric
embolism (PE) ii) lower risk for recurrent 3 2 2 2 2 1 surgery‡ b) Malabsorptive procedures COCs: 3 3 1 1 1 1
DVT/PE P/R: 1
b) Acute DVT/PE 4 2 2 2 2 2 History of a) Pregnancy-related 2 1 1 1 1 1
c) DVT/PE and established on cholestasis b) Past COC-related 3 2 2 2 2 1
anticoagulant therapy for at
least 3 months History of high 2 1 1 1 1 1
blood pressure
i) higher risk for recurrent 4* 2 2 2 2 2
DVT/PE during
pregnancy
ii) lower risk for recurrent 3* 2 2 2 2 2
History of 1 1 1 1 1 1
DVT/PE
pelvic
d) Family history (first-degree 2 1 1 1 1 1 surgery
relatives)
HIV High risk or HIV infected‡ 1 1 1 1 2 2 2 2
e) Major surgery
AIDS (see drug interactions) ठ1* 1* 1* 1* 3 2* 3 2*
(i) with prolonged 4 2 2 2 2 1
Clinically well on ARV If on treatment see drug interactions 2 2 2 2
immobilization
therapy§
(ii) without prolonged 2 1 1 1 1 1 Hyperlipidemias 2/3* 2* 2* 2* 2* 1*
immobilization
Hypertension a) Adequately controlled 3* 1* 2* 1* 1 1
f) Minor surgery without 1 1 1 1 1 1 hypertension
immobilization
b) Elevated blood pressure
Depressive 1* 1* 1* 1* 1* 1* levels (properly taken
disorders measurements)
Diabetes a) History of gestational DM 1 1 1 1 1 1 (i) systolic 140-159 or 3 1 2 1 1 1
mellitus (DM) only diastolic 90-99
Progestin-only pill

Progestin-only pill
Combined pill,

Combined pill,
Sub-condition

Sub-condition
Copper-IUD

Copper-IUD
patch, ring

patch, ring
LNG--IUD

LNG--IUD
Condition

Condition
Injection

Injection
Implant

Implant
I C I C I C I C I C I C I C I C I C I C I C I C
(ii) systolic ≥160 or diastolic 4 2 3 2 2 1 Sexually a) Current purulent cervicitis or 1 1 1 1 4 2* 4 2*
≥100‡ transmitted chlamydial infection or
c) Vascular disease 4 2 3 2 2 1 infections gonorrhea
Inflammatory (Ulcerative colitis, Crohn’s 2/3* 2 2 1 1 1 b) Other STIs (excluding HIV 1 1 1 1 2 2 2 2
bowel disease disease) and hepatitis)
Ischemic heart Current and history of 4 2 3 3 2 3 2 3 1 c) Vaginitis (including 1 1 1 1 2 2 2 2
disease‡ trichomonas vaginalis and
Liver tumors a) Benign bacterial vaginosis)
i) Focal nodular hyperplasia d) Increased risk of STIs 1 1 1 1 2/3* 2 2/3* 2
2 2 2 2 2 1
ii) Hepatocellular adenoma‡ Smoking a) Age < 35 2 1 1 1 1 1
4 3 3 3 3 1
b) Malignant‡ 4 3 3 3 3 1 b) Age > 35, < 15 cigarettes/day 3 1 1 1 1 1
Malaria 1 1 1 1 1 1 c) Age > 35, >15 cigarettes/day 4 1 1 1 1 1
Multiple risk (such as older age, smoking, 3/4* 2* 3* 2* 2 1 Solid organ a) Complicated 4 2 2 2 3 2 3 2
factors for diabetes and hypertension) transplantation‡ b) Uncomplicated 2* 2 2 2 2 2
arterial Stroke‡ History of cerebrovascular 4 2 3 3 2 3 2 1
cardiovascular accident
disease Superficial a) Varicose veins 1 1 1 1 1 1
Obesity a) >30 kg/m2 body mass index 2 1 1 1 1 1 venous b) Superficial thrombophlebitis 2 1 1 1 1 1
(BMI)
b) Menarche to < 18 years and thrombosis
2 1 2 1 1 1
> 30 kg/m2 BMI Systemic lupus a) Positive (or unknown) 4 3 3 3 3 3 1 1
erythematosus‡ antiphospholipid antibodies
Ovarian cancer‡ 1 1 1 1 1 1 b) Severe thrombocytopenia 2 2 3 2 2 2* 3* 2*
Parity a) Nulliparous 1 1 1 1 2 2 c) Immunosuppressive 2 2 2 2 2 2 2 1
b) Parous 1 1 1 1 1 1 treatment
Past ectopic 1 2 1 1 1 1 d) None of the above 2 2 2 2 2 2 1 1
pregnancy Thrombogenic 4* 2* 2* 2* 2* 1*
Pelvic a) Past, (assuming no current mutations‡
inflammatory risk factors of STIs) Thyroid a) Simple 1 1 1 1 1 1
disease (i) with subsequent 1 1 1 1 1 1 1 1 disorders goiter/hyperthyroid/hypothyroid
pregnancy Tuberculosis‡ a) Non-Pelvic 1* 1* 1* 1* 1 1
(ii) without subsequent 1 1 1 1 2 2 2 2 b) Pelvic 1* 1* 1* 1* 4 3 4 3
pregnancy Unexplained (suspicious for serious 2* 2* 3* 3* 4* 2* 4* 2*
b) Current 1 1 1 1 4 2* 4 2* vaginal bleeding condition) before evaluation
Peripartum a) Normal or mildly impaired Uterine fibroids 1 1 1 1 2 2
cardiomyopathy cardiac function Valvular heart a) Uncomplicated 2 1 1 1 1 1
‡ (i) < 6 months 4 1 1 1 2 2 disease b) Complicated‡ 4 1 1 1 1 1
(ii) > 6 months 3 1 1 1 2 2 Vaginal a) Irregular pattern without 1 2 2 2 1 1 1
b) Moderately or severely 4 2 2 2 2 2 bleeding heavy bleeding
impaired cardiac function patterns b) Heavy or prolonged bleeding 1* 2* 2* 2* 1* 2* 2*
Post-abortion a) First trimester 1* 1* 1* 1* 1* 1* Viral hepatitis a) Acute or flare 3/4* 2 1 1 1 1 1
b) Second trimester 1* 1* 1* 1* 2 2 b) Carrier/Chronic 1 1 1 1 1 1 1
c) Immediately post-septic 1* 1* 1* 1* 4 4 Drug Interactions
abortion Antiretroviral a) Nucleoside reverse 1* 1 1 1 2/3* 2* 2/3* 2*
Postpartum (in a) < 21 days 3 1 1 1 therapy (ARV) transcriptase inhibitors
non-
breastfeeding b) Non-nucleoside reverse 2* 2* 1 2* 2/3* 2* 2/3* 2*
women) b) > 21 days transcriptase inhibitors
1 1 1 1
Postpartum (in a) < 10 minutes after delivery of c) Ritonavir-boosted protease 3* 3* 1 2* 2/3* 2* 2/3* 2*
2 1
breastfeeding or the placenta inhibitors
non- b) 10 minutes after delivery of Anticonvulsant a) Certain anticonvulsants 3* 3* 1 2* 1 1
2 2
breastfeeding the placenta to < 4 weeks therapy (phenytoin, carbamazepine,
women, barbiturates, primidone,
including topiramate, oxcarbazepine)
post- caesarean c) > 4 weeks 1 1 b)Lamotrigine 3* 1 1 1 1 1
section) d) Puerperal sepsis 4 4 Antimicrobial a) Broad spectrum antibiotics 1 1 1 1 1 1
Pregnancy NA* NA* NA* NA* 4* 4* therapy b) Antifungals 1 1 1 1 1 1
Rheumatoid a) On immunosuppressive 2 1 2/3* 1 2 1 2 1 c) Antiparasitics 1 1 1 1 1 1
arthritis therapy
d) Rifampicin or rifabutin 3* 3* 1 2* 1 1
b) Not on immunosuppressive 2 1 2 1 1 1
therapy therapy
Schistosomiasis a) Uncomplicated I = initiation of contraceptive method; C = continuation of contraceptive method
1 1 1 1 1 1 * Please see the complete guidance for a clarification to this classification. www.cdc.gov/reproductivehealth/usmec
b) Fibrosis of the liver‡ 1 1 1 1 1 1 ‡ Condition that exposes woman to increased risk as a result of unintended pregnancy.
Severe 1 1 1 1 1 2 § Please refer to the US MEC guidance related to drug interactions at the end of this chart
dysmenorrhea