United States Medical Eligibility Criteria for Contraceptive Use 2010: A Review of Changes

Abstract

In the late 1990s, the World Health Organization (WHO) created the Medical Eligibility Criteria for Contraceptive Use (MEC), which provide evidence-based recommendations for safe and effective contraception in women with medical problems. The WHO MEC incorporate the best available evidence, are periodically updated, and are designed to be modified for specific populations. The US Centers for Disease Control and Prevention published US MEC in 2010. Changes to WHO guidelines for use in the US population include the following areas: breastfeeding, intrauterine device use, valvular heart disease, ovarian cancer, uterine fibroids, and venous thromboembolism. Medical conditions not covered by WHO recommendations but added to the US MEC include contraceptive guidance for women with inflammatory bowel disease, history of bariatric surgery, rheumatoid arthritis, endometrial hyperplasia, history of peripartum cardiomyopathy, and history of solid organ transplant. This article reviews the changes and additions to WHO MEC found in the US MEC.

Hormonal Contraception Use is Common Among Patients with Inflammatory Bowel Diseases and an Elevated Risk of Deep Vein Thrombosis

“…Several forms of IUD are marketed in the United States and are well tolerated, highly effective, and not associated with increased risk for thrombosis. 22, 23 Progesterone-only contraceptive pills, implants, and injectables also avoid exposure to exogenous estrogen. 24 …”

Promotion of Long‐Acting Reversible Contraception Among Adolescents and Young Adults

“…We further limited our analysis to women who were eligible for LARC. Women were determined to be eligible for LARC if they were sexually active (or seeking contraception for planned future sexual activity), not currently using a LARC method, did not actively plan to become pregnant, did not report being in exclusively same‐sex sexual relationships, and did not have absolute contraindications to use of all LARC methods (defined as Centers for Disease Control and Prevention Medical Eligibility Criteria Category 4) . Additionally, we excluded visits scheduled specifically for the purpose of LARC insertion, as these women had made decisions to initiate LARC prior to the study.…”

Running in Place: The Challenge of Prescribing Medications Today

“…Although clinical information generally changes faster than policy and regulatory restrictions, ultimately, the latter affects prescribing practice in important ways. The article in this issue by Osborne 4 is an excellent overview of prescriptive authority for certified nurse‐midwives and certified midwives in all 50 states. This article lists the Web sites for each state that summarize regulations pertinent to prescriptive authority for midwives.…”

“…Government Web resources tend to be current and often provide needed information. The article by Jacobson and Murphy 5 Regarding the Medical Eligibility Criteria for Contraceptive Use focuses on the latest document that modifies the World Health Organization evidence‐based material to reflect use in the United States. Downloading this document to a computer or tablet can enable the busy clinician to rapidly identify the contraceptive methods that are indicated or contraindicated for a woman with special conditions such as migraines or seizure disorders.…”