Table 3. Recommendations on the use and safety of different contraceptives for women with baseline risks*1.
| COC | POP | D/NE | ETG | Copper IUD | LNG IUD | ||||||||
| High BMI: | |||||||||||||
| a) BMI: ≥ 30 kg/m 2 | 2 | 1 | 1 | 1 | 1 | 1 | |||||||
| b) Menarche <18 and bmi: ≥ 30 kg/m 2 | 2 | 1 | D=2, NE=1 | 1 | 1 | 1 | |||||||
| Deep vein thrombosis (DVT) / pulmonary embolus (PE) | |||||||||||||
| a) history of DVT/PE | 4 | 2 | 2 | 2 | 1 | 2 | |||||||
| b) acute DVT/PE | 4 | 3 | 3 | 3 | 1 | 3 | |||||||
| c) DVT/PE on anticoagulants | 4 | 2 | 2 | 2 | 1 | 2 | |||||||
| d) family history (1st degree relatives) | 2 | 1 | 1 | 1 | 1 | 1 | |||||||
| e) major surgery | |||||||||||||
| (i) prolonged immobilization | 4 | 2 | 2 | 2 | 1 | 2 | |||||||
| (ii) brief immobilization | 2 | 1 | 1 | 1 | 1 | 1 | |||||||
| f) minimal surgical procedures without immobilization | 1 | 1 | 1 | 1 | 1 | 1 | |||||||
| Thrombophilia | 4 | 2 | 2 | 2 | 1 | 2 | |||||||
| Systemic lupus erythematosus (SLE): Women with SLE are at increased risk of ischemic heart disease, stroke and venous thromboembolism. The above recommendations assume that none of the above risks is present at the time of prescribing. Michael: bitte horziontalen Strich unter dieser Zeile entfernen | |||||||||||||
| a) positive (or unknown) antiphospholipid antibody status | 4 | 3 | 3 | 3 | 1 | 3 | |||||||
| b) severe thrombocytopenia | 2 | 2 | 3*2 2*3 | 2 | 3*2 2*3 | 2 | |||||||
| c) immunosuppressive therapy | 2 | 2 | 2 | 2 | 2*2 1*3 | 2 | |||||||
| d) none of the above | 2 | 2 | 2 | 2 | 1 | 2 | |||||||
| Viral hepatitis | |||||||||||||
| a) acute or reactivated | 3/4 | 1 | 1 | 1 | 1 | 1 | |||||||
| b) carrier | 1 | 1 | 1 | 1 | 1 | 1 | |||||||
| c) chronic | 1 | 1 | 1 | 1 | 1 | 1 | |||||||
| Liver cirrhosis | |||||||||||||
| a) mild (compensated) | 1 | 1 | 1 | 1 | 1 | 1 | |||||||
| b) severe (decompensated) | 4 | 3 | 3 | 3 | 1 | 3 | |||||||
| Liver tumors | |||||||||||||
| a) benign | |||||||||||||
| (i) focal nodular hyperplasia | 2 | 2 | 2 | 2 | 1 | 2 | |||||||
| (ii) hepatocellular adenoma | 4 | 3 | 3 | 3 | 1 | 3 | |||||||
| b) malignant | 4 | 3 | 3 | 3 | 1 | 3 | |||||||
| Age | |||||||||||||
| a) menarche to <18 | 1 | 1 | 2 | 1 | 2 | 2 | |||||||
| a) 18 to <40 | 1 | 1 | 1 | 1 | 1 | 1 | |||||||
| b) ≥ 40 | 2 | 1 | 2 | 1 | 1 | 1 | |||||||
| Smoking | |||||||||||||
| a) age <35 | 2 | 1 | 1 | 1 | 1 | 1 | |||||||
| b) age ≥ 35 | |||||||||||||
| (i) <15 cigarettes/day | 3 | 1 | 1 | 1 | 1 | 1 | |||||||
| (ii) ≥ 15 cigarettes/day | 4 | 1 | 1 | 1 | 1 | 1 | |||||||
| Hypertension | |||||||||||||
| a) systolic 140–159 or diastolic 90–99 mmHg | 3 | 1 | 2 | 1 | 1 | 2 | |||||||
| b) systolic ≥160 or diastolic ≥ 100 mmHg | 4 | 2 | 3 | 2 | 1 | 2 | |||||||
| c) with vascular damage | 4 | 2 | 3 | 2 | 1 | 1 | |||||||
| Category 1: Use unrestricted. | |||||||||||||
| Category 2: Benefits generally outweigh risks | |||||||||||||
| Category 3: Risks generally outweigh benefits | |||||||||||||
| Category 4: This method represents an unacceptable health risk | |||||||||||||
*1From the WHO Medical Eligibility Criteria for Contraceptive Use, 4th edition, 2010 (1); COC, combined oral, transdermal, or vaginal contraceptive (ethinyl estradiol or estradiol valerate + progestagen); POP, oral progestagen only preparation (progestagen only pill); D, depot medroxyprogesterone acetate; NE, Norethisterone enantate (depot progestagens); ETG, etonogestrel implant (progestagen implant); IUD, intrauterine device; LNG, levonorgestrel;
*2initial onset of treatment;
*3continued treatment