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Update: WHO Eligibility Criteria
In March 1994 and May 1995, two scientific working groups met at the World
Health Organization (WHO) in Geneva, Switzerland, to review the latest clinical and
epidemiological data on a wide variety of contraceptive methods. As a result of these
meetings, WHO produced a document that provides guidance to policymakers, FP program
managers and the scientific community in updating eligibility criteria for both initiation
and continuation of a wide range of FP methods, including: low-dose combined oral
contraceptives (COCs), combined injectable contraceptives (CICs), progestin-only pills
(POPs), depot-medroxyprogesterone acetate (DMPA), norethindrone enanthate (NET-EN),
Norplant® implants (NOR), emergency contraception (emergency contraceptive pills and
emergency use of IUDs), copper intrauterine devices (Copper IUDs), the
levonorgestrel-releasing IUD (LNG-IUD), barrier methods, female and male voluntary
sterilization, natural family planning methods (NFP) including coitus interruptus and
lactational amenorrhea.7
WHO Medical Eligibility
Criteria: Important Points
For many medical conditions, there are no restrictions on using
any of the contraceptive methods discussed.
Many restrictions on the use of high-dose COCs (i.e., those
containing a high dose of estrogen) do not apply to low-dose COCs.
Eligibility criteria for progestin-only methods are different
from those for combined estrogen/progestin methods. For example, use of COCs is more
restrictive than progestin-only contraception for women with the following conditions:
breastfeeding, hypertension,venous thromboembolism, stroke, and heart disease with
complications.
Age alone is not a sufficient criterion for denying a woman any
of the contraceptive methods.
Irregular menstrual bleeding generally does not disqualify a
woman from using any method.
Unexplained vaginal bleeding should be evaluated before deciding
whether or not a woman can use a method.
Risk of STDs is the main factor restricting the use of IUDs. Most
medical conditions are not contraindications for IUD use.
Persons at risk of STDs should be advised always to use condoms
in conjunction with other methods.
In general, as long as the client’s history is taken
correctly, clinical and laboratory diagnostic tests are not considered mandatory for the
safe use of the contraceptive methods reviewed.
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7 World Health Organization (WHO). 1996. Improving
Access to Quality Care in Family Planning. Medical Eligibility Criteria for Contraceptive
Use. WHO: Geneva. (A French translation is being prepared. You may obtain this report from
the Unit of Family Planning and Population, Family and Reproductive Health, World Health
Organization, Avenue Appia, 1211, Geneva 27, Switzerland.)
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