CDC updates recommendations on contraceptive use

The Centers for Disease Control and Prevention issued selected practice recommendations on contraceptive use last week as a companion to its 2010 recommendations on medical eligibility for contraception.

The recommendations cover intrauterine contraception, implants, injectables, combined hormonal contraceptives, progestin-only pills, the standard-days method, and male sterilization, among other topics. They are based on the World Health Organization's 2012 global family planning guidance but have been adapted for a U.S. audience or because of new evidence. Specifically, they include new guidance on the use of the combined contraceptive patch and vaginal ring and address four new subject areas: effectiveness of female sterilization, extended use of combined hormonal methods and bleeding problems, regular contraception after use of emergency contraception, and determination of when contraception is no longer needed.

Compared with the World Health Organization's guidance, the CDC recommendations also include changes to the grace period for reinjection with depot medroxyprogesterone acetate, different recommendations for tests and exams before initiating contraception and for managing bleeding irregularities, and a modified algorithm for missed doses of the contraceptive pill. The recommendations were published in Morbidity and Mortality Weekly Report on June 14. ACP Internist published an article on contraceptive methods in our June issue.