Women's Health Matters: CDC Contraception Guidance: U.S. Medical Eligibility Criteria for Contraceptive Use (US MEC) and U.S. Selected Practice Recommendations for Contraceptive Use (US SPR)-Handout (Slides)

Handout (Slides)

Pdf Summary

The 2024 updates to the U.S. Centers for Disease Control and Prevention’s (CDC) contraception guidelines—the Medical Eligibility Criteria for Contraceptive Use (US MEC) and Selected Practice Recommendations (US SPR)—emphasize improving access and person-centered, noncoercive contraceptive counseling. The US MEC provides evidence-based recommendations on the safety of various contraceptive methods for persons with specific medical conditions, now covering approximately 60 conditions with 1,800 recommendations. The 2024 revisions include expanded guidance on conditions such as sickle cell disease, chronic kidney disease (including dialysis), systemic lupus erythematosus, liver conditions, thrombosis risks, and solid organ transplant status. Notably, changes reflect updated assessments of risks related to venous thromboembolism (VTE), with many progestin-only contraceptives demonstrating lower thrombosis risk compared to combined hormonal contraception. For example, combined hormonal contraception is now considered unacceptable (category 4) for individuals with sickle cell disease, while progestin-only methods like levonorgestrel IUD and implants have lower risk classifications.<br /><br />The US SPR offers clinical guidance on contraception provision, management of side effects, and practical considerations such as medication use during IUD placement and managing bleeding irregularities during implant use. New recommendations include counseling about testosterone’s lack of contraceptive reliability in transgender and nonbinary persons and support for self-administered subcutaneous DMPA. The 2024 update advises against routine use of misoprostol for IUD placement due to insufficient pain reduction and side effects but supports lidocaine (paracervical block or topical) as a helpful option for pain control.<br /><br />Overall, the guidelines prioritize shared decision-making, respect for reproductive autonomy, and removal of unnecessary medical barriers, supporting providers to deliver safe, individualized contraceptive care. Updated online tools and an app facilitate guideline access. Clinical scenarios illustrate applying recommendations, such as contraceptive choices for persons with sickle cell disease balancing safety and thrombosis risk.

Keywords

CDC 2024 contraception guidelines

US MEC updates

US SPR clinical guidance

contraceptive counseling

sickle cell disease contraception

venous thromboembolism risk

progestin-only contraceptives

IUD placement pain management

transgender contraception counseling

shared decision-making in contraception