TEALE FENNING

Nick Raine-Fenning

UKMEC Category 1 – Unrestricted use

Age – menarche to <40 years

Parity – nulliparous and parous

Breastfeeding – >6 months postpartum

Postpartum – >21 days if not breastfeeding

Post-abortion – immediately first and second trimester, and post-

Past ectopic pregnancy

History of pelvic surgery

Minor surgery without immobilisation

Varicose veins

Non-migrainous headaches – mild or severe

Epilepsy – and not using liver enzyme-inducers

Depressive disorders

Vaginal bleeding – unsuspicious irregular, heavy or prolonged

Endometriosis

Benign ovarian tumour

Severe dysmenorrhoea

Gestational trophoblastic neoplasia – when hCG is normal

Cervical ectropion

Breast disease – benign breast disease or a family history of breast

Endometrial or ovarian cancer

Uterine fibroids – with or without distortion of the uterine cavity

PID – current; or past history of, with or without subsequent pregnancy

STI – current, vaginitis or increased risk of STI

HIV/AIDS – risk of HIV/AIDS, current HIV not using antiretroviral

Schistosomiasis, pelvic and non-pelvic tuberculosis, malaria

Diabetes – history of gestational disease

Thyroid disorders

Viral hepatitis – carrier

Anaemias – thalassaemia, iron deficiency

Raynaud’s disease – primary without lupus anticoagulant

Nick Raine-Fenning · Posted: Wed Feb 06, 2008 6:30 pm Post subject:

UKMEC Category 2 – Benefits generally outweigh risks

Age – ≥40 yearsa

Breastfeeding – between 6 weeks and 6 months postpartum and partially
breastfeeding (medium to low)

Smoking – aged <35 years, or aged ≥35 years and stopped smoking ≥1 year ago

Obesity – BMI ≥30–34 kg/m2

History of high blood pressure during pregnancy

Family history of VTE in a first-degree relative aged ≥45 years

Major surgery without prolonged immobilisation

Superficial thrombophlebitis

Known hyperlipidaemias – e.g. common hypercholesterolaemia or familial
combined hyperlipidaemia

Valvular and congenital heart disease – uncomplicated

Migraine headaches – without aura in women aged <35 years

Vaginal bleeding – suspicious for serious condition before evaluation

CIN and cervical cancer

HIV/AIDS – current HIV using antiretroviral therapy, or current AIDS and
using HAART

Diabetes – NIDDM and IDDM, non-vascular disease

Gallbladder disease – asymptomatic or treated with a cholecystectomy

History of cholestasis – pregnancy-related

Inflammatory bowel disease

Sickle cell disease

Raynaud’s disease – secondary without lupus anticoagulant

Non-liver enzyme-inducing antibiotics

Highly active antiretroviral therapy (HAART)

Nick Raine-Fenning · Posted: Wed Feb 06, 2008 6:31 pm Post subject:

UKMEC Category 3 – Risks generally outweigh benefits

Breastfeeding – between 6 weeks and 6 months postpartum and fully or almost fully breastfeeding

Postpartum – <21 days postpartum

Smoking – aged ≥35 years and smoking <15 cigarettes per day, or stopped smoking <1 year ago

Obesity – BMI 35–39 kg/m2

Cardiovascular disease – multiple risk factors for arterial cardiovascular disease

Hypertension – elevated blood pressure >140 to 159 mmHg systolic or >90 to 94 mmHg diastolic

Family history of VTE in a first-degree relative aged <45 years

Immobility (unrelated to surgery) – e.g. wheelchair use, debilitating illness

Known hyperlipidaemias – e.g. familial hypercholesterolaemia

Migraine headaches – without aura in women aged ≥35 years; or a past history of migraine with aura at any age

Breast disease – past history of breast cancer and no evidence of recurrence for 5 years; carriers of known gene mutations associated with breast cancer (e.g. BRCA1); undiagnosed mass

Diabetes – with nephropathy/retinopathy/neuropathy; or other vascular disease or diabetes of >20 years’ duration (category given will depend on disease severity)

Gallbladder disease – symptomatic medically treated or current

History of cholestasis – past COC-related

Cirrhosis – mild compensated disease

Drugs which induce liver enzymes – e.g. rifampicin, rifabutin, St John’s Wort, griseofulvin and certain anticonvulsants (i.e. phenytoin, carbamazepine, barbiturates, primidone, topiramate, oxcarbazepine)

Nick Raine-Fenning · Posted: Wed Feb 06, 2008 6:31 pm Post subject:

UKMEC Category 4 – Unacceptable health risk and should not be used

Breastfeeding – <6 weeks postpartum

Smoking – aged ≥35 years and smoking ≥15 cigarettes per day

Obesity – BMI ≥40 kg/m2

Cardiovascular disease – multiple risk factors for arterial cardiovascular disease

Hypertension – blood pressure ≥160 mmHg systolic and/ or ≥95 mmHg diastolic; or vascular disease

VTE – current (on anticoagulants) or past history

Major surgery with prolonged immobilisation

Known thrombogenic mutations

Current and history of ischaemic heart disease

Stroke

Valvular and congenital heart disease – complicated by pulmonary hypertension, atrial fibrillation, history of subacute bacterial endocarditis

Migraine headaches – with aura at any age

Gestational trophoblastic neoplasia – when hCG is abnormal

Breast disease – current breast cancer

Diabetes – with nephropathy, retinopathy, neuropathy or other vascular disease, or diabetes of >20 years’ duration (category given will depend on disease severity)

Viral hepatitis – active disease

Cirrhosis – severe decompensated disease

Liver tumours – benign and malignant

Raynaud’s disease – secondary with lupus anticoagulant and thus a tendency to thrombosis