ADDITIONAL CONDITIONS

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

I

  = Initiation of the method

C

  = Continuation of the method

  = Use the method

NA

  = Not applicable

Condition

Male and Female Condoms Spermicides Diaphragms Cervical Caps Lactational amenorrhea method!!
REPRODUCTIVE HISTORY
Parity  
Nulliparous (has not given birth) 1 1 1 1
Parous (has given birth) 1 1 2 2
< 6 weeks postpartum 1 1 NAv NAv
CARDIOVASCULAR DISEASE
Complicated valvular heart disease (pulmonary hypertension, risk of atrial fibrillation, history of subacute bacterial endocarditis)g 1 1 2 2
REPRODUCTIVE TRACT INFECTIONS AND DISORDERS
Cervical intraepithelial neoplasia 1 1 1 4
Cervical cancer 1 2 1 4
Anatomical abnormalities 1 1 NAw NAx
HIV/AIDSg
High risk of HIV 1 4 4 4
HIV-infected 1 3 3 3 Cy
AIDS 1 3 3 3 Cy
OTHERS
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

Condition

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.

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