Puzzling Over the Hurt Down-Under
Serious Mental Illness and Contraception
New 13-Cycle Vaginal Contraceptive System
The Future of Family Planning in Post-COVID America
New ASCCP Guidelines: Implications for FP
On the alert: mood disorders during 2020 stressors
Challenges old and new during the pandemic
Reproductive health in the time of Covid-19
Missed Pills: The Problem That Hasn’t Gone Away
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Digital Family Planning: the Future is Now
Irregular Bleeding Due to Contraceptives
Ouch! Best approaches to menstrual pain
Contraceptive efficacy: understanding how user and method characteristics play their part
Strategizing treatment for chronic heavy menstrual bleeding
Untangling the literature on obesity and contraception
High tech apps for no-tech FABM
Menstrual exacerbation of other medical conditions
From Princeton University: Thomas James Trussell (1949-2018)
The Short and Long of IUD Use Duration
Selecting a Method When Guidance Isn’t Clear-cut
Healthcare in the Time of Digital Expansion
The Scoop on Two New FDA-Approved Contraceptive Methods
Pregnancy of unknown location—meeting the challenge
Big “yes” (with caveats) to CHCs during perimenopause
The role of IUDs (LNG IUDs, too!) in emergency contraception
Combined pills’ effect on mood disorders
Abortion in the U.S.: safe, declining, and under threat
Hope for ovarian cancer screening test
Breast cancer still a small risk with some hormonal contraceptives
Record rate of HPV-related throat cancer
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Don’t Abstain from Your Role in Abstinence
Teens births declining but geographic ‘hotspots’ defy trend
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Do Women Really Need to Wait That Long?
Reassuring news on depression and OC use
PMDD: Genetic clues may lead to improved treatment
Breast cancer risk when there is a family history
Body weight link to breast and endometrial cancers (and 11 others)
Family Planning in 2017 and Beyond
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Managing implant users’ bleeding and spotting
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Postpartum Contraception: Now, Not Later
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LARC among teens increased 15-fold, but not enough
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Free tools: Easy access to the US Medical Eligibility Criteria for Contraceptive Use
Alcohol consumption when pregnancy is unwanted or unintended
Latest Data on Contraceptive Use in the United States
LateBreaker sampler from Contraceptive Technology conference
Emergency Contraceptive Pill Efficacy and BMI/Body Weight
Handout on Unintended Pregnancy and Contraceptive Choice
Ask About Withdrawal (Really!)
Rules to Practice By: Safety First and Cleanliness is Close to. . .
What’s Vanity Fair Got Against the NuvaRing?
Promising New Treatment for Hepatitis C
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The Recession’s Effect on Unintended Pregnancies
Lessons Learned from the Contraceptive CHOICE Project: The Hull LARC Initiative
Applying the “New” Cervical Cytology Guidelines in Your Practice
Acute Excessive Uterine Bleeding: New Management Strategies
Medical indications for IUD use in teens

In 2010, the Centers for Disease Control and Prevention (CDC) released the US Medical Eligibility Criteria for Contraceptive Use (US MEC), which provides guidance for healthcare providers on the safe use of contraceptive methods for patients with medical conditions or other characteristics. For example, there are recommendations on whether women with hypertension can use the pill and whether teenagers can use an intrauterine device (IUD). This guidance was adapted from the World Health Organization, and the recommendations are intended to serve as a source of clinical guidance to providers as they counsel their patients about choosing a contraceptive method; health-care providers should always consider the individual circumstances of each individual seeking family planning services.
The US MEC provides clinical guidance for safe use of contraceptive methods by women and men with various characteristics and medical conditions, with over 1800 recommendations pertaining to more than 60 conditions. CDC has developed several user-friendly tools to help providers access this guidance in the clinic setting. One popular tool is the US MEC wheel, which is similar to a pregnancy gestation wheel, but provides a subset of recommendations from the US MEC for many of the medical conditions and contraceptive methods. The medical conditions and patient characteristics are listed around the outside of the wheel and the contraceptive methods are included on an inner wheel. As the provider spins the inner wheel, a window reveals the recommendation for the specific medical condition and contraceptive method combination. The back of the wheel contains important additional information to the recommendations, as well as a list of conditions for which all methods can be used.
As an example, your patient is a healthy, 24-year-old woman, who just delivered her first infant 2 weeks ago. She had used combined oral contraceptives before her pregnancy, and would like to start using them again. You use the wheel to find the condition of < 21 days postpartum, and see that combined oral contraceptives are a Category 4, meaning that there is an unacceptable health risk for this woman to use combined oral contraceptives. However, progestin-only methods, including the implant, injection, and pills, are all Category 2, meaning that the advantages of using any of these methods outweigh the risks. Copper and levonorgestel IUDs are a Category 1 (no restriction) or Category 2. The information on the wheel is meant to be a useful provider tool; more information, including the full set of recommendations and the evidence for these recommendations can be found in the full US MEC document. For example, in that document, you would find that the reason for the Category 4 recommendation for combined oral contraceptives for a women < 21 days postpartum is due to evidence regarding increased risk of venous thromboembolism in the postpartum period. the inner wheel, a window reveals the recommendation for the specific medical condition and contraceptive method combination. The back of the wheel contains important additional information to the recommendations, as well as a list of conditions for which all methods can be used.
The full US MEC, plus other guidance documents (including the US Selected Practice Recommendations for Contraceptive Use and Providing Quality Family Planning Services), provider tools, videos, and training and continuing education resources, can be found at: http://www.cdc.gov/reproductivehealth/UnintendedPregnancy/Contraception_Guidance.htm
Please request the “US Medical Eligibility Criteria for Contraceptive Use (MEC) Wheel” at: http://wwwn.cdc.gov/dcs/RequestForm.aspx. You can also download a US MEC app for iPhone or iPad through iTunes.
— Deborah Kowal, MA, PA, President & CEO, Contraceptive Technology Communications, Inc.