WHO Medical Eligibility Criteria for Initiating Contraceptive Methods

1 Method can be used without restriction.

2 Advantages of method generally outweigh risks.

3 Method not usually recommended unless other, more appropriate methods are not available or not acceptable.

4 Method not to be used.

Anemia

Thalassemia

1

1

1

1

1

2

Sickle cell disease

2

1

1

1

1

2

Iron-deficiency anemia

1

1

1

1

1

2

Breast disease

Family history of cancer

1

1

1

1

1

1

Current breast cancer

4

4

4

4

4

1

Breast cancer in past, no evidence of disease for > 5 years

3

3

3

3

3

1

Undiagnosed breast mass

2

2

2

2

2

1

Benign breast disease

1

1

1

1

1

1

Cervical cancer

Cervical intraepithelial neoplasia

2

1

2

2

2

1

Awaiting treatment

2

1

2

2

4

4

Cervical ectropion

1

1

1

1

1

1

Depression

1

1

1

1

1

1

Diabetes mellitus

History of gestational disease

1

1

1

1

1

1

Without vascular disease

2

2

2

2

2

1

With end-organ damage or > 20 years' duration

3

2

3

2

2

1

Drug interactions

Antiretrovirals

2

2

2

2

2

2

Certain anticonvulsants

3

3

2

3

1

1

Griseofulvin (Grisactin)

2

2

1

2

1

1

Rifampin (Rifadin)

3

3

2

3

1

1

All other antibiotics

1

1

1

1

1

1

Endometrial cancer

1

1

1

1

4

4

Endometriosis

1

1

1

1

1

2

Gallbladder disease

Asymptomatic gallstones

2

2

2

2

2

1

Symptomatic gallstones, without cholecystectomy

3

2

2

2

2

1

Gallstones treated with cholecystectomy

2

2

2

2

2

1

Pregnancy-related cholestasis in past

2

1

1

1

1

1

Hormone-related cholestasis in past

3

2

2

2

2

1

Headaches

Nonmigrainous

1

1

1

1

1

1

Migrainous

Without aura, age < 35 years

2

1

2

2

2

1

Without aura, age ≥ 35 years

3

1

2

2

2

1

With aura, any age

4

2

2

2

2

1

HIV/AIDS

High risk

1

1

1

1

2

2

HIV infected

1

1

1

1

2

2

AIDS (without drug interactions)

1

1

1

1

3

3

Hypertension

During prior pregnancy, now resolved

2

1

1

1

1

1

Well controlled

3

1

2

1

1

1

Systolic BP 140-159 mm Hg or diastolic BP 90-99 mm Hg

3

1

2

1

1

1

Systolic BP ≥ 160 mm Hg or diastolic BP ≥ 100 mm Hg

4

2

3

2

2

1

With vascular disease

4

2

3

2

2

1

Ischemic heart disease

Past or current

4

2

3

2

2

1

Liver disease

Cirrhosis, mild

3

2

2

2

2

1

Cirrhosis, severe

4

3

3

3

3

1

Tumors, benign

4

3

3

3

3

1

Tumors, malignant

4

3

3

3

3

1

Viral hepatitis, carrier

1

1

1

1

1

1

Viral hepatitis, active

4

3

3

3

3

1

Obesity

BMI ≥ 30 kg per m2

2

1

1

1

1

1

Ovarian cancer

1

1

1

1

3

3

Ovarian cysts and benign tumors

1

1

1

1

1

1

Pelvic inflammatory disease

Past, with subsequent pregnancy