Additional conditions relating to emergency contraceptive pills:

Category 1: Repeated use; rape.

Category 2: History of severe cardiovascular complications (ischemic heart disease, cerebrovascular attack, or other thromboembolic conditions, and angina pectoralis).

Additional conditions relating to female sterilization:

Caution: Diaphragmatic hernia; kidney disease; severe nutritional deficiencies; previous abdominal or pelvic surgery; concurrent with elective surgery.

Delay: Abdominal skin infection; acute respiratory disease (bronchitis, pneumonia); systemic infection or gastroenteritis; emergency surgery (without previous counseling); surgery for an infectious condition; certain postpartum conditions (7 to 41 days after childbirth); severe pre-eclampsia/eclampsia; prolonged rupture of membranes (24 hours or more); fever during or immediately after delivery; sepsis after delivery; severe hemorrhage; severe trauma to the genital tract; cervical or vaginal tear at time of delivery); certain postabortion conditions (sepsis, fever, or severe hemorrhage; severe trauma to the genital tract; cervical or vaginal tear at time of abortion; acute hematometra); subacute bacterial endocarditis; unmanaged atrial fibrillation.

Special arrangements: Coagulation disorders; chronic asthma, bronchitis, emphysema, or lung infection; fixed uterus due to previous surgery or infection; abdominal wall or umbilical hernia; postpartum uterine rupture or perforation; postabortion uterine perforation.

Conditions relating to vasectomy:

No special considerations: High risk of HIV, HIV-infected, sickle cell disease.

Caution: Young age; depressive disorders; diabetes; previous scrotal injury; large varicocele or hydrocele; cryptorchidism (may require referral); lupus with positive (or unknown) antiphospholipid antibodies; lupus and on immunosuppressive treatment.

Delay: Active STIs (excluding HIV and hepatitis); scrotal skin infection; balanitis; epididymitis or orchitis; systemic infection or gastroenteritis; filariasis; elephantiasis; intrascrotal mass.

Special arrangements: AIDS (AIDS-related illness may require delay); coagulation disorders; inguinal hernia; lupus with severe thrombocytopenia.

Conditions relating to male and female condoms, spermicides, diaphragms, cervical caps, and the lactational amenorrhea method:

All other conditions listed on the previous pages that do not appear here are a category 1 or NA for male and female condoms, spermicides, diaphragms, and cervical caps and not listed in the Medical Eligibility Criteria for the Lactational Amenorrhea Method.


  = Use the method


  = Do not use the method


  = Initiation of the method


  = Continuation of the method

  = Use the method


  = Not applicable


Male and Female Condoms Spermicides Diaphragms Cervical Caps Lactational amenorrhea method!!
Nulliparous (has not given birth) 1 1 1 1
Parous (has given birth) 1 1 2 2
< 6 weeks postpartum 1 1 NAv NAv
Complicated valvular heart disease (pulmonary hypertension, risk of atrial fibrillation, history of subacute bacterial endocarditis)g 1 1 2 2
Cervical intraepithelial neoplasia 1 1 1 4
Cervical cancer 1 2 1 4
Anatomical abnormalities 1 1 NAw NAx
High risk of HIV 1 4 4 4
HIV-infected 1 3 3 3 Cy
AIDS 1 3 3 3 Cy
History of toxic shock syndrome 1 1 3 3
Urinary tract infection 1 1 2 2
Allergy to latexz 3 1 3 3

v Wait to fit/use until uterine involution is complete.

w Diaphragm cannot be used in certain cases of uterine prolapse.

x Cap use is not appropriate for a client with severely distorted cervical anatomy.

y Caution: Women with HIV or AIDS should receive appropriate ARV therapy and exclusively breastfeed for the first 6 months of a baby's life, introduce appropriate complementary foods at 6 months, and continue breastfeeding through 12 months.

z Does not apply to plastic condoms, diaphragms, and cervical caps.

‡‡Additional conditions relating to lactational amenorrhea method:

Medication used during breastfeeding: To protect infant health, breastfeeding is not recommended for women using such drugs as anti-metabolites, bromocriptine, certain anticoagulants, corticosteroids (high doses), cyclosporine, ergotamine, lithium, moodaltering drugs, radioactive drugs, and reserpine.

Conditions affecting the newborn that may make breastfeeding difficult: Congenital deformities of the mouth, jaw, or palate; newborns who are small-for-date or premature and needing intensive neonatal care; and certain metabolic disorders.

Conditions relating to fertility awareness methods:

A = Accept

C = Caution

D = Delay


Symptoms-based methods Calendar-based methods
Age: post menarche or perimenopause C C
Breastfeeding < 6 weeks postpartum D Daa
Breastfeeding ≥ 6 weeks postpartum C Dbb
Postpartum, not breastfeeding Dcc Daa
Postabortion C Ddd
Irregular vaginal bleeding D D
Vaginal discharge D A
Taking drugs that affect cycle regularity, hormones, and/or fertility signs D/Cee D/Cee
Diseases that elevate body temperature    
Acute D A
Chronic C A

aa Delay until she has had 3 regular menstrual cycles.

bb Use caution after monthly bleeding or normal secretions return (usually at least 6 weeks after childbirth).

cc Delay until monthly bleeding or normal secretions return (usually < 4 weeks postpartum).

dd Delay until she has had one regular menstrual cycle.

ee Delay until the drug’s effect has been determined, then use caution.

Previous Chapter Previous Page Next Page Next Chapter