TABLE 4.
All contraception, ranked by MEC
| Method | MEC | Advantages | Disadvantages |
|---|---|---|---|
| IUD | 2/3 a | Most effective, long-acting, reversible | Heavy or irregular bleeding |
| Depomedroxyprogesterone acetate | 2 | Highly effective, decreased anemia | Decreased BMD, irregular bleeding |
| Progestin implant | 2 | Most effective, long-acting, no BMD decrease | Irregular bleeding |
| Combined oral contraceptives (COC) | 2/4 a | Menstrual regulation, decreased anemia | Contraindicated: uncontrolled HTN, age 35 years, smokers, cardiac vasculopathy, active liver disease, personal history of MI, stroke or DVT, first-pass liver metabolism, GI disturbance may decrease absorption |
| Contraceptive patch | 2/4 a | First-pass metabolism avoided | Contraindicated: uncontrolled HTN, age 35 years, smokers, cardiac vasculopathy, active liver disease, personal history of MI, stroke, or DVT |
| Vaginal ring | 2/4 a | First-pass metabolism avoided, lower circulating estrogen | Contraindicated: uncontrolled HTN, active liver disease, personal history of MI, stroke, or DVT |
| Progestin-only pill | 2 | Avoid estrogen adverse effects | Less effective than COC, first-pass metabolism |
| Condoms | 1 | No drug interactions, protects from STDs | Less effective |
| Barrier methods | 1 | No drug interactions | Less effective |
a
Complicated solid organ transplant SOT = high risk of graft failure, rejection, or presence of significant cardiac vasculopathy.
Abbreviations: BMD, bone mineral density; DVT, deep venous thrombosis; GI, gastrointestinal; HTN, hypertension; IUD, intrauterine device; MEC, medical eligibility criteria; MI, myocardial infarction; STI, sexually transmitted infection.