CDC issues recommendations for contraceptive use

In this week’s Morbidity and Mortality Weekly Report (MMWR), the United States Center for Disease Control and Prevention published the 2024 US Medical Eligibility Criteria for Contraceptive Use. The updated report offers insight and guidance for using or recommending specific contraceptive methods depending on a patient’s characteristics or medical conditions.

According to the report, the CDC reviewed scientific data in a meeting from January 25, 2023, to January 27, 2023, and used the data to inform its recommendations. This report will replace the 2016 US Medical Eligibility Criteria for Contraceptive Use and include some notable changes.

The 2024 US Medical Eligibility Criteria is used alongside the US Selected Practice Recommendations for Contraceptive Use. Both documents are modeled after or adapted from global guidance from the World Health Organization.

Although the document is comprehensive and offers detailed recommendations for various patient populations, the CDC highlighted some notable changes from the previous document.

For instance, there are new recommendations for individuals with chronic kidney disease, including patients with nephrotic syndrome or patients on hemodialysis or peritoneal dialysis.

Additionally, the document revises recommendations on contraceptive use for patients with a variety of medical conditions or characteristics, including individuals who are breastfeeding, postpartum, and postabortion. Other factors considered include obesity, surgery, history of deep venous thrombosis or pulmonary embolism with or without anticoagulant therapy, thrombophilia, superficial venous thrombosis, valvular heart disease, peripartum cardiomyopathy, systemic lupus erythematosus, cirrhosis, liver tumor, sickle cell disease, and solid organ transplantation.

There are revised recommendations for individuals with a higher risk of HIV and those taking antiretrovirals to prevent or treat HIV infections.

Finally, the report also adds new contraceptive methods, such as varying doses or formulations of combined oral contraceptives, contraceptive patches, vaginal rings, progestin-only pills, levonorgestrel intrauterine devices, and vaginal pH modulators.

The CDC states that “recommendations are meant to serve as a source of evidence-based clinical guidance for health care providers and can support the provision of person-centered contraceptive counseling and services in a noncoercive manner. Healthcare providers should always consider the individual clinical circumstances of each person seeking contraceptive services. This report is not intended to be a substitute for professional medical advice for individual patients; when needed, patients should seek advice from their healthcare providers about contraceptive use.”