Selected woman’s characteristics
Breastfeeding Status:
Time Selected: Between 0 hours and 12 months
Method Selected: Diaphragms / Cervical Cap
Note: Some methods are unavailable for specific time ranges

Description

Diaphragm: covering over the cervix

Spermicide: substance with chemicals placed in the vagina.
 

How it works

Diaphragm: Forms a barrier to prevent sperm and egg from meeting

Spermicide: kills or immobilizes sperm.

Effectiveness to prevent pregnancy

Diaphragm (with spermicide): 94% with correct and consistent use, 88% as commonly used

Spermicide (alone): 82% with correct and consistent use, 72% as commonly used

Comments

Diaphragms and cervical caps are generally to be used with spermicide.
 
 
 

Conditions / Subconditions

Breastfeeding Status:

No breastfeeding status was selected using the "Women’s characteristics" filters.

Breastfeeding Category Clarifications/Special considerations
Diaphragm Spermicide
a) < 6 weeks postpartum 1 NA Clarification: The diaphragm and cap are unsuitable until uterine involution is complete.
b) ≥ 6 weeks postpartum 1 1
Non-breastfeeding Category Clarifications/Special considerations
Diaphragm Spermicide
a) < 6 weeks postpartum 1 NA Clarification: The diaphragm and cap are unsuitable until uterine involution is complete.
b) ≥ 6 weeks postpartum 1 1

Medical Condition:

No medical conditions were selected using the "Women’s characteristics" filters.

Cardiovascular disease Category Clarifications/Special considerations
Current and history of ischaemic heart disease 1
Stroke 1
Diabetes Category Clarifications/Special considerations
a) History of gestational disease 1
b) Non-vascular disease 1
i) non-insulin dependent 1
ii) insulin dependent 1
c) Nephropathy/retinopathy/neuropathy 1
d) Other vascular disease or diabetes of > 20 years’ duration 1
Headaches Category Clarifications/Special considerations
a) Non-migrainous (mild or severe) 1
b) Migraine
i) without aura, at any age 1
ii) with aura, at any age 1
HIV WHO Stage 3 or 4 Category Clarifications/Special considerations
Diaphragm Spermicide
Severe or advanced HIV clinical disease (WHO stage 3 or 4) 3 3
Hypertension Category Clarifications/Special considerations
a) History of hypertension, where blood pressure CANNOT be evaluated (including hypertension in pregnancy) 1
b) Adequately controlled hypertension, where blood pressure CAN be evaluated 1
c) Elevated blood pressure levels (properly taken measurements) 1
i) systolic 140-159 or diastolic 90-99 mm Hg 1
ii) systolic ≥ 160 or diastolic ≥ 100 mm Hg 1
d) Vascular disease
Obesity Category Clarifications/Special considerations
a) > 30 kg/m2 BMI 1
b) Menarche to < 18 years and ≥30 kg/m2 BMI 1
Pelvic infection Category Clarifications/Special considerations
a) Past PID (assuming no current risk factors for STIs)
i) with subsequent pregnancy 1
ii) without subsequent pregnancy 1
b) PID – current 1
c) Current purulent cervicitis or chlamydial infection or gonorrhoea 1
d) Other STIs (excluding HIV and hepatitis) 1
e) Vaginitis (including Trichomonasvaginalis and bacterial vaginosis) 1
f) Increased risk of STIs 1
Tuberculosis Category Clarifications/Special considerations
a) Non-pelvic 1
b) Pelvic 1
Venous thromboembolism Category Clarifications/Special considerations
a) History of DVT/PE 1
b) Acute DVT/PE 1
c) DVT/PE and established on anticoagulant therapy 1
d) Family history (first-degree relatives) 1

Drug Interactions:

No drug interactions were selected using the "Women’s characteristics" filters.

Anticonvulsants Category Clarifications/Special considerations
a) Certain anticonvulsants,(phenytoin, carbamazepine, barbiturates, primidone, topiramate, oxcarbazepine) 1
b) Lamotrigine 1
Antimicrobial Therapy Category Clarifications/Special considerations
a) Broad-spectrum antibiotics 1
b) Antifungals 1
c) Antiparasitics 1
Rifampin/rifabutin 1
Antiretroviral Therapy Category Clarifications/Special considerations
Diaphragm Spermicide
a) Nucleoside reverse transcriptase inhibitors (NRTIs)
Abacavir (ABC) 3 3
Tenofovir (TDF) 3 3
Zidovudine (AZT) 3 3
Lamivudine (3TC) 3 3
Didanosine (DDI) 3 3
Emtricitabine (FTC) 3 3
Stavudine (D4T) 3 3
b) Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
Efavirenz (EFV) 3 3
Etravirine (ETR) 3 3
Nevirapine (NVP) 3 3
Rilpivirine (RPV) 3 3
c) Protease inhibitors (PIs)
Ritonavir-boosted atazanavir (ATV/r) 3 3
Ritonavir-boosted lopinavir (LPV/r) 3 3
Ritonavir-boosted darunavir (DRV/r) 3 3
Ritonavir (RTV) 3 3
d) Integrase inhibitors
Raltegravir (RAL) 3 3

Other:

No other conditions were selected using the "Women’s characteristics" filters.

Adolescents Category Clarifications/Special considerations
Adolescents 1 Special consideration: Adolescents In general, adolescents are eligible to use any method of contraception and must have access to a variety of contraceptive choices.
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Adolescents

    Special consideration: Adolescents Special consideration: Adolescents In general, adolescents are eligible to use any method of contraception and must have access to a variety of contraceptive choices. Age alone does not constitute a medical reason for denying any method to adolescents. While some concerns have been expressed regarding the use of certain contraceptive methods in adolescents (e.g. the use of progestogen-only injectables by those below 18 years), these concerns must be balanced against the advantages of avoiding pregnancy.

    It is clear that many of the same eligibility criteria that apply to older clients apply to young people. However, some conditions (e.g. cardiovascular disorders) that may limit use of some methods in older women do not generally affect young people since these conditions are rare in this age group. Social and behavioural issues should be important considerations in the choice of contraceptive methods by adolescents.

    For example, in some settings, adolescents are also at increased risk for STIs, including HIV. While adolescents may choose to use any one of the contraceptive methods available in their communities, in some cases, using methods that do not require a daily regimen may be more appropriate. Adolescents, married or unmarried, have also been shown to be less tolerant of side-effects and therefore have high discontinuation rates.

    Method choice may also be influenced by factors such as sporadic patterns of intercourse and the need to conceal sexual activity and contraceptive use. For instance, sexually active adolescents who are unmarried have very different needs from those who are married and want to postpone, space or limit pregnancy. Expanding the number of method choices offered can lead to improved satisfaction, increased acceptance and increased prevalence of contraceptive use.

    Proper education and counselling both before and at the time of method selection can help adolescents address their specific problems and make informed and voluntary decisions. Every effort should be made to prevent service and method cost from limiting the options available.
Smoking Category Clarifications/Special considerations
a) Age < 35 years 1
b) Age > 35 years
i) < 15 cigarettes/day 1
ii) > 15 cigarettes/day 1
Note: Some methods are unavailable for specific time ranges