Clinical meaning
The CDC US Medical Eligibility Criteria (US MEC) is the evidence-based framework NPs use to determine contraceptive safety for patients with specific medical conditions. The US MEC categorizes each combination of medical condition and contraceptive method into four categories: Category 1 (no restriction), Category 2 (advantages generally outweigh risks), Category 3 (theoretical or proven risks usually outweigh advantages), and Category 4 (unacceptable health risk). The framework addresses conditions affecting estrogen safety (VTE risk, cardiovascular disease, migraine with aura), conditions affecting IUD use (pelvic infection, uterine anomalies), and conditions requiring special consideration (breastfeeding, postpartum timing, drug interactions).
Diagnosis & workup
Diagnostics & workup: - Blood pressure (required before any estrogen-containing method) - BMI calculation - Pregnancy test - Complete medical and surgical history review - Current medication review for interactions - Migraine characterization (with or without aura) - Thrombophilia screening only if positive family history of inherited thrombophilia