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U S. medical eligibility criteria for contraceptive use, 2010 : adapted from the World Health Organization Medical Eligibility Criteria for Contraceptive Use, 4th edition
Filetype[PDF - 1.35 MB]


Details:
  • Personal Authors:
  • Corporate Authors:
    Centers for Disease Control and Prevention (U.S.)
  • Pubmed ID:
    22717514
  • Description:
    Introduction -- Methods -- How to use this document -- Keeping guidance up to date -- Appendix A. Summary of changes from WHO MEC to U.S. MEC -- Appendix B. Combined hormonal contraceptives -- Appendix C. Progestin-only contraceptives -- Appendix D. Emergency contraceptive pills -- Appendix E. Intrauterine Ddevices -- Appendix F. Copper IUDs for emergency contraception -- Appendix G. Barrier methods -- Appendix H. Fertility awareness-based methods -- Appendix I. Lactational amenorrhea method -- Appendix J. Coitus Interruptus (withdrawal) -- Appendix K. Sterilization -- Appendix L. Summary of hormonal contraceptives and IUDs -- Appendix M. Potential drug interactions: hormonal contraceptives and antiretroviral drugs -- Abbreviations and acronyms -- Participants.

    "CDC created U.S. Medical Eligibility Criteria for Contraceptive Use, 2010, from guidance developed by the World Health Organization (WHO) and finalized the recommendations after consultation with a group of health professionals who met in Atlanta, Georgia, during February 2009. This guidance comprises recommendations for the use of specific contraceptive methods by women and men who have certain characteristics or medical conditions. The majority of the U.S. guidance does not differ from the WHO guidance and covers >60 characteristics or medical conditions. However, some WHO recommendations were modified for use in the United States, including recommendations about contraceptive use for women with venous thromboembolism, valvular heart disease, ovarian cancer, and uterine fibroids and for postpartum and breastfeeding women. Recommendations were added to the U.S. guidance for women with rheumatoid arthritis, history of bariatric surgery, peripartum cardiomyopathy, endometrial hyperplasia, inflammatory bowel disease, and solid organ transplantation. The recommendations in this document are intended to assist health-care providers when they counsel women, men, and couples about contraceptive method choice. Although these recommendations are meant to serve as a source of clinical guidance, health-care providers should always consider the individual clinical circumstances of each person seeking family planning services." - P. 1.

    Prevention of unintended pregnancy among women at risk for human immunodeficiency virus (HIV) infection or infected with HIV is critically important. One strategy for preventing unintended pregnancies in this population is improving access to a broad range of effective contraceptive methods. In 2010, CDC published U.S. Medical Eligibility Criteria for Contraceptive Use, 2010 (US MEC), providing evidence-based guidance for the safe use of contraceptive methods among women with certain characteristics or medical conditions, including women who are at high risk for HIV infection or are HIV infected. Recently, CDC assessed the evidence regarding hormonal contraceptive use and the risk for HIV acquisition, transmission, and disease progression. This report summarizes that assessment and the resulting updated guidance. These updated recommendations affirm the previous guidance, which stated that 1) the use of hormonal contraceptives, including combined hormonal contraceptives, progestin-only pills, depot medroxyprogesterone acetate (DMPA), and implants, is safe for women at high risk for HIV infection or infected with HIV (US MEC category 1), and 2) all women who use contraceptive methods other than condoms should be counseled regarding the use of condoms and the risk for sexually transmitted infections. However, a clarification is added to the recommendation for women at high risk for HIV infection who use progestin-only injectables to acknowledge the inconclusive nature of the body of evidence regarding the association between progestin-only injectable use and HIV acquisition. The clarification also notes the importance of condom use and other HIV preventive measures, expansion of the variety of contraceptive methods available (i.e., contraceptive method mix), and the need for further research on these issues.

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