Contraception Knowledge Centre
Case Study
WHO guidance on contraception
Resource Text
The WHO’s Medical Eligibility Criteria for Contraceptive Use (WHOMEC) aims to provide guidance regarding which patients can use which contraceptive methods safely. It defines the following categories.
- WHO 1 - no restriction of use
- WHO 2 - advantages outweigh risks
- WHO 3 - risks usually outweigh advantages
- WHO 4 - unacceptable health risk
So for a patient like yours, aged 25 with focal migraine, wanting to start a contraceptive method, the WHO classification is as follows.
- COC - WHO 4
- Progesterone only pill (POP) -WHO 2
- Depo-Provera injection - WHO 2
- Implanon implant - WHO 2
- Intra-uterine system (IUS) - WHO 2
- Intra-uterine device (IUD) - WHO 1
For a patient who develops focal migraine whilst using a method, the classification is different.
- COC - WHO 4
- POP - WHO 3
- Depo-Provera - WHO 3
- Implanon - WHO 3
- IUS - WHO 3
- IUD - WHO 1
Further Reading
| Question | Answer | Feedback |
|---|---|---|
| If a method has been classified as WHO 4 for patients with condition X it means it can be used without restriction | True False |
Please select an answer. The correct answer is - False [your answer:? ] WHO 4 means the method for patients with condition X should not be used because of unacceptable health risks. |
| Which is the only method for which there is no restriction of use with focal migraine? | COC POP Depo-Provera Implanon IUS IUD |
Please select an answer. The correct answer is - IUD [your answer:? ] The IUD is the only method with WHO 1 for use with pre-existing focal migraine. |
| The WHO classification is different if a patient develops a focal migraine whilst using a contraceptive method. | True False |
Please select an answer. The correct answer is - True [your answer:? ] If a patient develops focal migraine whilst using a contraceptive method, the WHO classification is different. This reflects the importance of reviewing the method with any change in a patient's medical history whilst using that method, particularly in this case as the hormonal methods may have contributed to the causation of the migraine. The cause of the migraine should be evaluated. |
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