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Contraception - Management
UK Medical Eligibility Criteria for use of fertility awareness-based methods
- The UK Medical Eligibility Criteria are a set of evidence-based recommendations designed to help women select the most appropriate method of contraception for specific clinical conditions without imposing necessary restrictions [FFPRHC, 2006a].
- There are no medical conditions which become worse due to the use of fertility awareness–based methods. In general, these methods can be provided without concern. However, several conditions make their use more complex. With some conditions, the woman requires special counselling by a more highly trained provider; with other conditions, use of a fertility awareness–based method should be delayed until the condition has resolved. Table 2 lists the conditions that make use of a fertility awareness–based method more complex. These conditions are placed into categories of Accept, Caution, and Delay, which are defined in Table 1.
- Women with conditions which make pregnancy an unacceptable risk should be advised that fertility awareness–based methods may not be appropriate for them because of other methods have lower failure rates with typical use.
Table 1. UK Medical Eligibility Criteria (UKMEC) for fertility awareness–based methods.
Category | Definition |
|---|
UKMEC Accept | There is no medical reason to deny the method to a woman in this circumstance. |
UKMEC Caution | The procedure is normally conducted in a routine setting, but with extra preparation and precautions. For fertility awareness–based methods, this usually means that special counselling may be needed to ensure correct use of the method by a woman in this circumstance. |
UKMEC Delay | Use of this method should be delayed until the condition is evaluated or corrected. Alternative temporary methods of contraception should be offered. |
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Table 2. UK Medical Eligibility Criteria (UKMEC) for use of cervical mucus fertility awareness–based method.
Clinical feature | UKMEC Accept No restrictions | UKMEC Caution Special counselling required | UKMEC Delay Delay until condition has resolved.
Offer alternative method. |
|---|
Lifestage | — | In the first 2 years post-menarche Perimenopause | — |
Breastfeeding | | >= 6 weeks After menses begin | < 6 weeks postpartum |
Postpartum, and not breastfeeding | >= 4 weeks | — | < 4 weeks |
Post-abortion | — | Post-abortion | — |
Vaginal bleeding | — | — | Irregular vaginal bleeding |
Vaginal discharge | — | — | Vaginal discharge |
Drugs | — | — | Use of drugs* which affect hormones, fertility signs, and/or the regularity of the menstrual cycle |
* Certain mood-altering drugs, such as lithium, tricyclic antidepressants, and anti-anxiety therapies, as well as certain antibiotics and anti-inflammatory drugs, may alter cycle regularity or affect fertility signs. |
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