UKMEC

1
UKMEC
2
UK What?

• The United Kingdom Medical Eligibility Criteria
• Most contraceptive users are medically fit and
  can use any contraceptive method safely
• However, some medical conditions lead to a
  theoretically increased health risk when certain
  contraceptive methods are used
• Most trials of new contraceptives deliberately
  exclude those with chronic medical conditions
• Little direct evidence for safe prescribing

3
WHOMEC

• Developed by the WHO for international
  organisations to update or develop their own
  guidelines in line with national health policies,
  resources etc.
• Last updated 2008

4
UKMEC

• First published in 2006
• Aimed at contraceptive use for contraceptive
  purposes, as there may be a different
  risk-benefit profile in other cases
• Criteria relate to the safety of using a
  contraceptive method by women with certain
  medical conditions or using certain drugs

5
UKMEC

• UKMEC 2009 supersedes the 2006 version and uses
  evidence from the WHOMEC 4th edition
• Its not easy to summarise

6
Categories
7
Commonly Used Contraceptive Methods

• CHC Combined Hormonal Contraception
• POP Progestogen Only Pill
• DMPA Depot Medroxyprogesterone Acetate
• NET-EN Norethisterone Enantanate
• IMP Implant (Progesterone Only)
• Cu-IUD Copper Coil
• LNG-IUD Levonorgestrel Releasing IUD

8
What sort of things make a difference?
9
Considerations

• Female Factors
• Breastfeeding
• Post-partum
• Abortion
• Gestational hypertension
• Unexplained Vaginal Bleeding
• Dysmenorrhoea
• Gestational Trophoblastic Disease
• CIN
• Cervical Cancer
• Breast Disease
• Endometrial Ca
• Ovarian Ca
• Fibroids
• Anatomical Abnormalities

• Infections
• STI
• HIV / AIDS
• TB
• Hepatitis

10
Considerations

• Cancers
• Cervical Cancer
• Breast Cancer
• Endometrial Ca
• Ovarian Ca
• Anatomical Abnormalities
• Liver tumours

• GI Conditions
• Diabetes
• Gallbladder Disease
• Cholestasis
• Cirrhosis
• Liver tumours
• IBD

11
Considerations

• Drugs
• Antiretrovirals
• Anticonvulsants
• Antibiotics

• Blood Conditions
• Anaemia
• Raynauds
• SLE
• Thrombogenic Mutations
• Hyperlipidaemia

12
Considerations

• Cardiovascular
• Smoking
• Obesity
• Multiple risk factors for Cardiovascular
  Disease
• Hypertension,
• Ischaemic Heart Disease
• Stroke
• Hyperlipidaemia
• Valvular / Congenital Heart Disease
• Migraine

13
Abbreviations

• CHC Combined Hormonal Contraception
• POP Progestogen Only Pill
• DMPA Depot Medroxyprogesterone Acetate
• NET-EN Norethisterone Enantanate
• IMP Implant (Progesterone Only)
• Cu-IUD Copper Coil
• LNG-IUD Levonorgestrel Releasing IUD

14
(No Transcript)
15
(No Transcript)
16
(No Transcript)
17
(No Transcript)
18
(No Transcript)
19
(No Transcript)
20
(No Transcript)
21
(No Transcript)
22
(No Transcript)
23
(No Transcript)
24
(No Transcript)
25
(No Transcript)
26
(No Transcript)
27
DRUGS
28
(No Transcript)
29
(No Transcript)
30
(No Transcript)
31
The End

• Boring, wasnt it?
• Refs
• http//www.fsrh.org/pdfs/UKMEC2009.pdf
• http//www.fsrh.org/pdfs/ukmecsummarysheets2009.pd
  f
• http//www.hillingdongp.org.uk/_borders/ukmec_page
  s_28-29.pdf