Episode Details

Episode 59: What is Keto?  

Discussion about the benefits and risks of the keto diet. Introduction about the CDC Contraceptive app.

Introduction: Contraception App Update (CDC)
By Cecilia Covenas, MD, and Hector Arreaza, MD

Today is July 16, 2021.

What is the CDC Contraception App? 

The CDC has updated their contraception app to assist health care providers in counseling women, men, and couples on the different contraceptive methods. The app is called Contraception. When you open the app, it has three main sections. MEC by Condition, MEC by Method and SPR. 

MEC stands for Medically Eligibility Criteria, it is a guide to choose the safest contraceptive for patients with certain medical conditions. SPR stands for Selected Practice Recommendations. It is a guide for common topics such as initiation of a particular method, or tests needed before starting a contraceptive, or follow up, etc. The last update to the app was this past March, and it includes new features. Now, you can select up to three conditions at once, move from one condition to another easily, and see additional info for a particular condition and method.

How to use it?

There are three main sections: MEC by condition, MEC by method, and SPR. 

The US MEC recommendations are divided into four categories, from 1 through 4.

Category 1 means no restriction to use that contraceptive (it’s good to use, it’s displayed with a dark green background).

Category 2 means the advantages of using the method generally outweighs the risk (OK to use, it’s marked with a light green color).

Category 3 means the risks of the method generally outweighs the advantages (this is not a good choice choose something else, it’s shown with a light red color).

Category 4 means there is an unacceptable health risk for using that method with that specific condition (do not use this contraceptive method! It is shown with a dark red color background).

For example, a 36-year-old female with obesity (BMI 32) and migraines with aura would like to start Combined Hormonal Contraceptives (CHC or the “pill”), will this be safe for her?

Open the app, choose MEC by condition, then select the conditions “Menarche to <40 years for CHC”, then under Headaches, tap on “Migraines with aura,” and under Obesity, choose “BMI >30”. Tap on Continue.

The recommendations for each condition are displayed, and we can move to each condition easily by tapping on the arrows on the top of the page. In this patient, for example, the “pill” (CHC) is category 1 for her age, category 2 for obesity with BMI >30, but it’s category 4 for migraines with aura. You can see more info by tapping on the plus sign in each recommendation. Based on the evidence, this patient is not a good candidate for CHC. So, do not prescribe it!

Let's say the same patients asks about IUD (Mirena®), acronym LNG IUD, is it a good choice? Let’s tap on MEC by Method, then find the IUD and select the same conditions: age, migraine with aura, and obesity. The IUD is category 1, you can prescribe it safely.

To expand your knowledge even more, tap on the SPR icon and select the recommendations on initiation of the IUD. According to the Selected Practice Recommendations (SPR), the IUD can be inserted at any time if it is reasonably certain the patient is not pregnant. You can insert IUD after obtaining consent, and going over the risks, benefits, and alternatives, under proper supervision if you are a resident.

This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it’s sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home.

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