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Understanding and using
WHO Medical Eligibility Criteria for
Contraceptive Use (WHO MEC, 2010)
Prof. Aboubakr Elnashar elnashar53@hotmail.com
Objective Understanding and using
Tables
Wheel
Contraceptive Method Choice
1. Safety
2. Effectiveness
3. Availability (accessibility and affordability)
4. Acceptability.
Copper
IUD
Levonor
gestrel
IUD
Implant Injection POP Combined
pill;
Patch
Ring
Based on the current scientific evidence
Category 1: Safe
No restriction for use
Category 2: Usable
Advantages outweigh risks (theoretical or proven):
careful follow-up may be required
Category 3: Not recommended
Risks(theoretical or proven) outweigh advantages
Category 4: No use
Unaccepted health risk
I= Initiation of contraception
C= Continuation of contraception, NA= Not applicable
Breastfeeding: CHC
< 1 month postpartum:
Category 3
>1 month postpartum:
Category 2
DVT & PE: CHC
Acute DVT/PE: Category 4
DVT/PE on anticoagulant
for at least 3 months
Higher risk of recurrence
Thrombophilia
Cancer
Recurrence
: Category 4
Lower risk of recurrence
: Category 3
Bariatric Surgery: CHC
Restrictive procedures:
(gastric band or sleeve):
Category 1
Malabsorptive procedures Malabsorption from method or SE of long term
vomiting/diarrhea
: COCs: Category 3
: P/Ring: Category 1
Hypertension: CHC
Adequately controlled:
Category 3
Elevated BP levels:
S 140-159 OR D 90-99
: Category 3
S > 160 OR D > 100
: Category 4
Vascular disease: Category 4
Hypertension during pregnancy: Category 2
Obesity: CHC
BMI > 30: Category 2
{Possible increased risk
of VTE, MI, stroke}
Rheumatic Diseases: CHC SLE
Positive or unknown
APL antibodies: C4
Thrombocytopenia: C2
Immunosuppression: C2
None of above: C2
Rheumatoid Arthritis
Immunosuppression:
C2
Non-suppressed: C2
Age: CHC
Menarche to <40 years:
Category 1
> 40 years old: Category 2
Smoking: CHC <35 and smoke: 2
>35 and smoke <15/day: 3
>35 and smoke > 15/day: 4
Thank you Aboubakr Elnashar
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