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Quick Reference Chart for the WHO Medical Eligibility Criteria for Contraceptive Use –
to initiate or continue use of combined oral contraceptives (COCs), depot-medroxyprogesterone acetate (DMPA), progestin-only implants, copper intrauterine device (Cu-IUD)
CONDITION
Implants Cu-IUD
CONDITION
Implants Cu-IUD
Pregnancy
Gestational
trophoblastic
Breastfeeding
Persistently elevated β-hCG levels or malignant disease Postpartum
< 21days with other risk factors for VTE Breast disease
≥ 21 to 42 days with other risk factors for VTE < 48 hours including immediate post-placental Past w/ no evidence of current disease for 5 yrs Uterine distortion due to fibroids or anatomical abnormalities
STIs/PID
Current purulent cervicitis, chlamydia, gonorrhea Postabortion
Current pelvic inflammatory disease (PID) Multiple risk factors for cardiovascular disease
Hypertension
History of (where BP cannot be evaluated) Very high individual risk of exposure to STIs Pelvic tuberculosis
Elevated BP (systolic 140 - 159 or diastolic 90 - 99) Diabetes
Elevated BP (systolic ≥ 160 or diastolic ≥ 100) Symptomatic gall bladder disease (current or medically treated)
Deep venous
Cholestasis
thrombosis
(history of)
(DVT) and
pulmonary
DVT/PE, established on anticoagulant therapy Hepatitis
embolism (PE)
Major surgery with prolonged immobilization eptiv tions/family_planning/en/inde Known thrombogenic mutations
Cirrhosis
Ischemic heart disease (current or history of) or stroke (history of)
Known hyperlipidemias
Liver tumors (hepatocellular adenoma and malignant hepatoma)
Complicated valvular heart disease
Systemic lupus
Positive or unknown antiphospholipid antibodies erythematosus
Headaches
Drug interac-
Nucleoside reverse transcriptase inhibitors Migraine without aura (age < 35 years) tions, including
Non-nucleoside reverse transcriptase inhibitors Ritonavir, ritonavir-boosted protease inhibitors Unexplained vaginal bleeding (prior to evaluation)
Category 1 There are no restrictions for use.
Unlike previous versions of the MEC Quick Reference Chart, this version includes a complete list of all conditions classified as Category 3 and 4 by WHO. Category 2 Generally use; some follow-up may be needed.
I/C (Initiation/Continuation): A woman may fall into either one category or another, depending on whether she is initiating or continuing to use a method. For
example, a client with current PID who wants to initiate IUD use would be considered as Category 4, and should not have an IUD inserted. However, if she develops Category 3 Usual y not recommended; clinical judgment and
PID while using the IUD, she would be considered as Category 2. This means she could general y continue using the IUD and be treated for PID with the IUD in continuing access to clinical services are required for use.
place. Where I/C is not marked, the category is the same for initiation and continuation.
Category 4 The method should not be used.
NA (not applicable): Women who are pregnant do not require contraception.
NC (not classified): The condition is not part of the WHO classification for this method.
* Evaluation of an undiagnosed mass should be pursued as soon as possible.
** Anticonvulsants include: phenytoin, carbamazepine, barbiturates, primidone, topiramate, oxcarbazepine,
and lamotrigine. Lamotrigine is a category 1 for implants.

Source: http://www.fptraining.org/sites/fptrp/files/handout2-quickrefchartmec-2011.pdf