Summary Chart of U.S. Medical Eligibility Criteria for …

1 ConditionSub-ConditionCu-IUDLNG-IUDI mplantDMPAPOPCHCICICICICICICD iabetesa) History of gestational disease111111b) Nonvascular diseasei) Non-insulin dependent122222ii) Insulin dependent122222c) Nephropathy/retinopathy/neuropathy 12232 3/4*d) Other vascular disease or diabetes of >20 years duration 12232 3/4*DysmenorrheaSevere211111 Endometrial cancer 42421111 Endometrial hyperplasia111111 Endometriosis211111 Epilepsy (see also Drug Interactions)11 1* 1* 1* 1*Gallbladder diseasea) Symptomatici) Treated by cholecystectomy122222ii) Medically treated122223iii) Current122223b) Asymptomatic122222 Gestational trophoblastic disease a) Suspected GTD (immediate postevacuation)i) Uterine size first trimester 1* 1* 1* 1* 1* 1*ii) Uterine size second trimester 2* 2* 1* 1* 1* 1*b) Confirmed GTDi) Undetectable/non-pregnant -hCG levels 1* 1* 1* 1* 1* 1* 1* 1*ii) Decreasing -hCG levels 2* 1* 2* 1* 1* 1* 1* 1*iii)

2 Persistently elevated -hCG levels or malignant disease, with no evidence or suspicion of intrauterine disease 2* 1* 2* 1* 1* 1* 1* 1*iv) Persistently elevated -hCG levels or malignant disease, with evidence or suspicion of intrauterine disease 4* 2* 4* 2* 1* 1* 1* 1*Headachesa) Nonmigraine (mild or severe)11111 1*b) Migrainei) Without aura (includes menstrual migraine)11111 2*ii) With aura11111 4*History of bariatric surgery a) Restrictive procedures111111b) Malabsorptive procedures11113 COCs: 3P/R: 1 History of cholestasisa) Pregnancy related111112b) Past COC related122223 History of high blood pressure during pregnancy111112 History of Pelvic surgery111111 HIVa) High risk for HIV1*1*1*1*1 111b) HIV infection 1* 1* 1* 1* i) Clinically well receiving ARV therapy1111If on treatment, see Drug Interactions ii)

3 Not clinically well or not receiving ARV therapy 2121If on treatment, see Drug InteractionsSummary Chart of Medical Eligibility Criteria for Contraceptive UseConditionSub-ConditionCu-IUDLNG-IUDI mplantDMPAPOPCHCICICICICICICAgeMenarche to <20 yrs:2 Menarche to <20 yrs:2 Menarche to <18 yrs:1 Menarche to <18 yrs:2 Menarche to <18 yrs:1 Menarche to <40 yrs:1 20 yrs:1 20 yrs:118-45 yrs:118-45 yrs:118-45 yrs:1 40 yrs:2>45 yrs:1>45 yrs:2>45 yrs:1 Anatomicalabnormalities a) Distorted uterine cavity44b) Other abnormalities22 Anemiasa) Thalassemia211111b) Sickle cell disease 211112c) Iron-deficiency anemia211111 Benign ovarian tumors(including cysts)111111 Breast diseasea) Undiagnosed mass12 2* 2* 2* 2*b) Benign breast disease111111c) Family history of cancer111111d) Breast cancer i) Current144444ii) Past and no evidence of current disease for 5 years133333 Breastfeedinga) <21 days postpartum 2* 2* 2* 4*b) 21 to <30 days postpartum i)

4 With other risk factors for VTE 2* 2* 2* 3* ii) Without other risk factors for VTE 2* 2* 2* 3*c) 30-42 days postpartum i) With other risk factors for VTE 1* 1* 1* 3* ii) Without other risk factors for VTE 1* 1* 1* 2*d) >42 days postpartum 1* 1* 1* 2*Cervical cancerAwaiting treatment42422212 Cervical ectropion111111 Cervical intraepithelial neoplasia122212 Cirrhosisa) Mild (compensated)111111b) Severe (decompensated)133334 Cystic fibrosis 1* 1* 1* 2* 1* 1*Deep venous thrombosis (DVT)/Pulmonary embolism (PE)a) History of DVT/PE, not receiving anticoagulant therapyi) Higher risk for recurrent DVT/PE122224ii) Lower risk for recurrent DVT/PE 122223b) Acute DVT/PE222224c) DVT/PE and established anticoagulant therapy for at least 3 monthsi) Higher risk for recurrent DVT/PE22222 4*ii) Lower risk for recurrent DVT/PE22222 3*d) Family history (first-degree relatives)111112e) Major surgeryi) With prolonged immobilization122224ii) Without prolonged immobilization111112f )

5 Minor surgery without immobilization111111 Depressive disorders 1* 1* 1* 1* 1* 1*Abbreviations: ARV = antiretroviral; C=continuation of contraceptive method; CHC=combined hormonal contraception (pill, patch, and, ring); COC=combined oral contraceptive; Cu-IUD=copper-containing intrauterine device; DMPA = depot medroxyprogesterone acetate; I=initiation of contraceptive method; LNG-IUD=levonorgestrel-releasing intrauterine device; NA=not applicable; POP=progestin-only pill; P/R=patch/ring; SSRI=selective serotonin reuptake inhibitor; Condition that exposes a woman to increased risk as a result of pregnancy.

6 *Please see the complete guidance for a clarification to this classification: :1 No restriction (method can be used)3 Theoretical or proven risks usually outweigh the advantages2 Advantages generally outweigh theoretical or proven risks4 Unacceptable health risk (method not to be used)ConditionSub-ConditionCu-IUDLNG-IUD I mplantDMPAPOPCHCICICICICICICH ypertensiona) Adequately controlled hypertension 1* 1* 1* 2* 1* 3*b) Elevated blood pressure levels (properly taken measurements)i) Systolic 140-159 or diastolic 90-99 1* 1* 1* 2* 1* 3*ii) Systolic 160 or diastolic 100 1* 2* 2* 3* 2* 4*c)

7 Vascular disease 1* 2* 2* 3* 2* 4*Inflammatory bowel disease(Ulcerative colitis, Crohn s disease)11122 2/3*Ischemic heart disease Current and history of123233234 Known thrombogenic mutations 1* 2* 2* 2* 2* 4*Liver tumorsa) Benigni) Focal nodular hyperplasia122222ii) Hepatocellular adenoma 133334b) Malignant (hepatoma)133334 Malaria111111 Multiple risk factors for atherosclerotic cardiovascular disease( , older age, smoking, diabetes, hypertension, low HDL, high LDL, or high triglyceride levels)12 2* 3* 2* 3/4*Multiple sclerosisa) With prolonged immobility111213b) Without prolonged immobility111211 Obesitya) Body mass index (BMI) 30 kg/m2 111112b) Menarche to <18 years and BMI 30 kg/m2 111212 Ovarian cancer 111111 Paritya) Nulliparous221111b) Parous111111 Past ectopic pregnancy111121 Pelvic inflammatory diseasea) Pasti) With subsequent pregnancy11111111ii) Without subsequent pregnancy22221111b) Current4 2*4 2*1111 Peripartum cardiomyopathy a) Normal or mildly impaired cardiac function i)

8 <6 months221114ii) 6 months221113b) Moderately or severely impaired cardiac function222224 Postabortiona) First trimester 1* 1* 1* 1* 1* 1*b) Second trimester 2* 2* 1* 1* 1* 1*c) Immediate postseptic abortion44 1* 1* 1* 1*Postpartum (nonbreastfeeding women) a) <21 days1114b) 21 days to 42 daysi) With other risk factors for VTE111 3*ii) Without other risk factors for VTE1112c) >42 days1111 Postpartum (in breastfeeding or non-breastfeeding women, including cesarean delivery)a) <10 minutes after delivery of the placenta i) Breastfeeding 1* 2* ii) Nonbreastfeeding 1* 1*b) 10 minutes after delivery of the placenta to <4 weeks 2* 2*c) 4 weeks 1* 1*d) Postpartum sepsis44CS314239-AUpdated in 2020.

9 This Summary sheet only contains a subset of the recommendations from the MEC. For complete guidance, see: Most contraceptive methods do not protect against sexually transmitted diseases (STDs). Consistent and correct use of the male latex condomreduces the risk of STDs and Chart of Medical Eligibility Criteria for Contraceptive UseConditionSub-ConditionCu-IUDLNG-IUDI mplantDMPAPOPCHCICICICICICICP regnancy4*4* NA* NA* NA* NA*Rheumatoid arthritisa) On immunosuppressive therapy21211 2/3*12b) Not on immunosuppressive therapy111212 Schistosomiasisa) Uncomplicated111111b) Fibrosis of the liver 111111 Sexually transmitted diseases (STDs)a)

10 Current purulent cervicitis or chlamydial infection or gonococcal infection4 2*4 2*1111b) Vaginitis (including trichomonas vaginalis and bacterial vaginosis)22221111c) Other factors relating to STDs 2*2 2* 21111 Smokinga) Age <35111112b) Age 35, <15 cigarettes/day111113c) Age 35, 15 cigarettes/day111114 Solid organ transplantation a) Complicated32322224b) Uncomplicated22222 2*Stroke History of cerebrovascular accident12233234 Superficial venous disordersa) Varicose veins111111b) Superficial venous thrombosis (