Update on the contraceptive contraindications

Area of Science:

• Reproductive Health
• Family Planning
• Medical Guidelines

Background:

• Contraceptive options have expanded, but not all methods suit women with specific medical conditions.
• Ensuring safe contraception is vital for women at higher risk of pregnancy complications.
• Evidence-based guidance is essential for healthcare providers selecting appropriate contraceptive methods.

Purpose of the Study:

• To provide an updated review of main contraceptive contraindications.
• To analyze the rationale behind recommendations for women with various medical disorders.
• To scrutinize national adaptations of international contraceptive guidelines.

Main Methods:

• Referenced the World Health Organization Medical Eligibility Criteria for Contraceptive Use (WHO-MEC) from 2015.
• Analyzed recommendations for cardiovascular, rheumatic, neurologic, gynecological, and endocrine disorders.
• Examined French, British, and American national adaptations of the WHO-MEC.

Main Results:

• Medical Eligibility Criteria (MEC) generally align on recommendations.
• Noticed variations in categorization for conditions with limited or controversial evidence, particularly for hormonal contraceptives.
• Identified medical conditions or characteristics included in some MECs but not others.

Conclusions:

• MECs are valuable tools for prescribing safe and acceptable contraceptive methods.
• Consulting multiple MECs can be beneficial for complex cases.
• Clinical judgment should always guide contraceptive method selection, as MECs are guidelines.