7/20/2014 WHO MEC for gastrointestinal disorders

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World Health Organization medical eligibility for contraceptive use: Gastrointestinal conditions

Condition COC CIC P/R POP

DMPA

NET­EN

LNG/ETG

Implants

Cu­IUD

LNG­IUD

Gall­bladder disease

Symptomatic

Treated bycholecystectomy

2 2 2 2 2 2 1 2

Medically treated 3 2 3 2 2 2 1 2

Current 3 2 3 2 2 2 1 2

Asymptomatic 2 2 2 2 2 2 1 2

History of cholestasis

Pregnancy­related 2 2 2 1 1 1 1 1

Past COC­related 3 2 3 2 2 2 1 2

Viral hepatitis

Acute or flare 3/4 to initiatemethod

2 to continuemethod

3 to initiatemethod

2 to continuemethod

3/4 to initiatemethod

2 to continuemethod

1 1 1 1 1

Carrier or chronic disease 1 1 1 1 1 1 1 1

Cirrhosis

7/20/2014 WHO MEC for gastrointestinal disorders

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Mild (compensated) 1 1 1 1 1 1 1 1

Severe (decompensated) 4 3 4 3 3 3 1 3

Liver tumors

Benign hepatocellularadenoma

4 3 4 3 3 3 1 3

Benign focal nodularhyperplasia

2 2 2 2 2 2 1 2

Malignant (hepatoma) 4 3/4 4 3 3 3 1 3

1: A condition for which there is no restriction for the use of the contraceptive method.2: A condition where the advantages of using the method generally outweigh the theoretical or proven risks.3: A condition where the theoretical or proven risks usually outweigh the advantages of using the method.4: A condition which represents an unacceptable health risk if the contraceptive method is used.

COC: low­dose combined oral contraceptive; CIC: combined injectable contraceptives; P: combined patch; R: combined vaginal ring; POP: progestogen­only pill;DMPA: depot medroxyprogesterone acetate; NET­EN: norethisterone enantate; LNG: levonorgestrel; ETG: etonogestrel; ECP: emergency contraceptive pill;Cu­IUD: copper intrauterine device; LNG­IUD: levonorgestrel­releasing IUDs; E­IUD: copper­IUD for emergency contraception; BARR: barrier methods; FAB:fertility awareness­based methods; LAM: lactational amenorrhoea method; CI: coitus interruptus; STER: female and male sterilization.

Reproduced with permission from: Medical Eligibility Criteria for Contraceptive Use ­ 3rd Ed. Available at: http://www.who.int/reproductive­health/publications/mec/summary.html. Copyright © 2006 World Health Organization. Revised from: Medical Eligibility Criteria for Contraceptive Use, 2009update. Available at: http://www.who.int/reproductive­health/publications/mec/.

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