Exams/Tests Needed Before Contraceptive Initiation

EXAMS/TESTS NEEDED BEFORE CONTRACEPTIVE INITIATION
Exams/Tests Copper-
containing
IUD
Levonorgestrel-
releasing IUD
Implant DMPA Combined
Hormonal
Contra
ceptive
Progestin-
only Pill
EXAMINATIONS
Blood pressure C C C C C
Weight (BMI) (weight [kg]/ height [m]²) —¹ —¹ —¹ —¹ —¹ —¹
Clinical breast exam C C C C C C
Bimanual exam and
cervical inspection
A A C C C C
LABORATORY TESTS
Glucose C C C C C C
Lipids C C C C C C
Liver enzymes C C C C C C
Hemoglobin C C C C C C
Thrombogenic mutations C C C C C C
Cervical cytology (Pap smear) C C C C C C
STD screening with lab tests —² —² C C C C
HIV screening with lab tests C C C C C C
NOTES

Key: DMPA = depot medroxyprogesterone acetate; IUD = intrauterine device

Class A: essential and mandatory in all circumstances for safe and effective use of the contraceptive method.

Class B: contributes substantially to safe and effective use, but implementation may be considered within the public health and/or service context; the risk of not performing an examination or test should be balanced against the benefits of making the contraceptive method available.

Class C: does not contribute substantially to safe and effective use of the contraceptive method.

¹Weight (BMI) measurement is not needed to determine medical eligibility for any methods of contraception because all methods can be used or generally can be used among obese women. However, measuring weight and calculating BMI at baseline might be helpful for monitoring any changes and counseling women who might be concerned about weight change perceived to be associated with their contraceptive method.

²Most women do not require additional STD screening at the time of IUD insertion if they have already been screened according to CDC’s STD Treatment Guidelines (available at http://www.cdc.gov/std/
treatment
). If a woman has not been screened according to guidelines, screening can be performed at the time of IUD insertion, and insertion should not be delayed. Women with purulent cervicitis or current chlamydial infection or gonorrhea should not undergo IUD insertion.

³In instances in which blood pressure cannot be measured by a provider, blood pressure measured in other settings can be reported by the woman to her provider.

REFERENCES

Curtis KM, Jatlaoui TC, Tepper NK, et al. U.S. Selected Practice Recommendations for Contraceptive Use, 2016. MMWR Recomm Rep 2016;65:1-66. DOI: http://dx.doi.org/10.15585/mmwr.rr6504a1

(Rev. 1/2019)