Medical eligibility criteria for contraceptive use
WHO's Medical Eligibility Criteria for Contraceptive Use provides recommendations for policy-makers to help rationalize the provision of various contraceptives in relation to the most up-to-date information available on the safety of the methods for people with certain health conditions.
The Medical Eligibility Criteria for Contraceptive Use, first published in 1996, provides detailed guidance regarding who can use contraceptive methods safely.
The fourth edition of this document, published in 2009, includes 1870 recommendations related to the use of all widely available temporary and permanent contraceptive methods for women with more than 70 conditions and also includes information for men regarding condom use and sterilization.
The recommendations are provided by assigning Categories 1 to 4 - with Category 1 indicating that there are no restrictions for use of the method and Category 4 indicating that use of the method presents an unacceptable health risk. Category 2 is assigned when the advantages of using the method generally outweigh risks and Category 3 is assigned when the health risks of use usually outweigh the contraceptive advantages. For example, oral contraceptive use by women with a history of gestational diabetes was assigned Category 1 whereas its use by women with diabetes without vascular disease was assigned Category 2. By contrast, women with diabetes with vascular disease were assigned a Category 3 or 4, depending on the severity of their disease.
The guidance was based on recommendations of an expert working group meeting held at WHO Headquarters in Geneva on 1-4 April 2008, that included representatives from nine international agencies, with 43 participants from 23 countries. The fourth edition includes guidance for new medical condition, systemic lupus erythematosus and guidance for 12 new sub-conditions has been added to medical conditions that already exist within the 3rd edition. Together, these changes represent a substantial update in guidance from the third edition.