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