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Latebreakers

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

Make Me Cry: Depression Link (Again)?

Managing implant users’ bleeding and spotting

Zika: Updated guidance for providers

Pharmacist-prescribed contraceptives

Hot off the press! 2016 MEC and SPR

Zika virus fears prompt increased request for abortion in nations outlawing abortions

Opioid use epidemic among reproductive-age women

Good news on the family planning home front!

War Against Planned Parenthood Hurts Women

Win-win for both treatment and prevention

Center of the Storm

Ambivalence

Menopause, mood, mental acuity, and hormone therapy

Emergency contraception for teens

Postpartum Contraception: Now, Not Later

Reproductive tract infections, sexually transmitted infections, or sexually transmitted diseases: “a rose by any other name…”

Are we practicing what we preach?

Be alert to VTE in hormonal contraceptive users

LARC among teens increased 15-fold, but not enough

Brain cancer and hormonal contraception

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

Numbers matter, so make them simple for patients

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

Whatever happened to PID?

Update on Emergency Contraception

Contraceptivetechnology.com New and Improved

Free tools: Easy access to the US Medical Eligibility Criteria for Contraceptive Use
March 2015

 

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.

US MEC

 

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.