CDC Releases Guide to Contraception Use Safety

The CDC recently released the U S. Medical Eligibility Criteria for Contraceptive Use, 2010, adapted from World Health Organization recommendations and intended to outline specific characteristics or medical conditions that may interfere with safe contraception use.

The document is intended for use by health care providers when counseling individuals about contraceptive choices, but is freely available to the public and includes some useful tables of considerations related to numerous contraceptive methods. It also includes a table of contraceptive failure rates with perfect and typical use (i.e., what percent of women get unintentionally pregnant in the first year with each method), and how many women continue to use each method after one year.

The guide is a little bit opaque to navigate and read, putting data for each method in its own appendix and number-coding the recommendations. I’m linking directly to these appendices below – for each, the first column is the list of relevant conditions (like smoking status), and the second column, Category, gives a number code from 1-4 indicating how the risks/benefits of the method balance out for any particular condition. The third column provides any relevant explanation.

For example, use of combined oral contraceptives in those who are ≥35 years of age and who smoke ≥15 cigarettes/day is given a score of “4,” meaning “A condition that represents an unacceptable health risk if the contraceptive method is used.” The third column explains the cardiovascular risk associated with smoking and using the pill.

The guides:

• Appendix B: Combined Hormonal Contraceptives (including the pill, patch, and ring)
• Appendix C: Progestin-Only Contraceptives
• Appendix D: Emergency Contraceptive Pills
• Appendix E: Intrauterine Devices
• Appendix F: Copper Intrauterine Devices for Emergency Contraception
• Appendix G: Barrier Methods (includes male and female condoms, spermicides, and diaphragms with spermicide or cervical cap)
• Appendix H: Fertility Awareness-Based Methods (including symptom-based and calendar-based methods)
• Appendix I: Lactational Amenorrhea (i.e., breastfeeding for birth spacing/control)
• Appendix J: Coitus Interruptus (Withdrawal) (okay, looking at this topic, I can’t help giggling that the CDC has labeled all of these documents as “early release”)
• Appendix K: Male and Female Sterilization

The CDC also provides appendices summarizing the info for hormonal contraceptives/IUDs and limited data on possible interactions between hormonal contraception and antiretroviral therapies.