SAN FRANCISCO – Pop quiz: Do you know which contraceptive methods are safe for women who are postpartum or who smoke? How about for women who have diabetic nephropathy or migraine with aura?
Handy online tools and smart-phone apps from the Centers for Disease Control and Prevention now offer recommendations for contraceptive choices. The U.S. Medical Eligibility Criteria for Contraception, or MEC (MMWR 2010;59:1-6), now has a newer companion document, the U.S. Selected Practice Recommendations for Contraception, released by the U.S. Centers for Disease Control and Prevention (MMWR 2013;62:1-46), Dr. Jody Steinauer said at a conference on women’s health sponsored by the University of California, San Francisco.
The U.S. version of the MEC features four color-coded tables that compare contraceptive methods and more than 60 medical conditions or characteristics. Each pair of method and condition is scored for safety on a scale of 1-4.
A score of 1 (color-coded dark green) means there are no concerns about the method to be used in that scenario. A score of 2 (light green) means that generally the advantages outweigh the risks of the method, said Dr. Steinauer, of the university.
A score of 3 (pink) suggests there is a "relative contraindication" in which there are some concerns, but the advantages of using that contraceptive method outweigh the risks for that patient. "You might talk with the woman about using a different method and if she decides to use the method with a 3 score, you would counsel her about the risks but would still prescribe it," she said. A score of 4 (red) means there’s an absolute contraindication to the method for that condition.
The MEC is available in an app for iPhone or iPad. The app lists choices by condition or by method; the online tables can be printed out and the options viewed all at once, she said.
"We have these hanging around at our clinic, and all of the residents carry them on their iPhones as well," she said. "It’s a really useful document."
The companion Selected Practice Recommendations for Contraception provide advice on how to use contraceptive methods in clinical practice. For example, there are recommendations on how long to use a backup contraceptive method once it has been started, special considerations for each method, and what to do when there are missed or late doses.
Dr. Steinauer reported having no financial disclosures,
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