1. Contraception The way to evidence

2. A 42 year‑old woman P5+1 was wearing an IUD for 6 months ,that was removed 2 months ago because of partial expulsion(2nd expulsion)

6. No contraceptive method is contraindicated by age alone. RCOG FFPRHC Guidance Grade C 2005 Women aged over 40 years can be advised that:

7. Women should be counseled for the risks and non-contraceptive benefits of all contraceptive methods. Medical eligibility criteria for contraceptive ( MECC ) WHO 2004

8. The WHO Medical Eligibility Criteria The WHO Medical Eligibility Criteria for Contraceptive Use provides evidence-based recommendations to ensure that women can select the most appropriate method of contraception without unnecessary medical barriers. RCOG FFPRHC Guidance Grade C 2005

9. WHO Medical Eligibility Criteria for Contraceptive Use (WHOMEC) 2004 / 2008 Eligibility rather than ineligibility (or contraindication) : 4 Categories

10. Category 1: The use is unrestricted (Used in any circumstances) Category 2: The advantages outweigh the theoretical or proven risks. ( Generally can be used) Category 3: The risks outweigh the benefit. (Not used unless other appropriate methods are not available or acceptable) Category 4: The use an unacceptable health risk (Method not to be used)

13. B. Progestagen Implants: Implanon Norplant and Implanon

15. Applicator Obturator cannula

17. D. Injectables NET-EN and DMPA

18. C. Progestin only pills (POP)

19. WHO Medical Eligibility Criteria: Diabetes IUD Mirena PO Implant PO Injectable POP E+P P - I - R 1 1 1 1 1 History of G. Diabetes 2 2 2 2 2 Uncomplicated Diabetes 2 2 2 2 3 Diabetes + other Risk factor 2 2 3 2 4 1-Vascular Diabetes (Nephropathy, Retinopathy, Neuropathy) 2-Diabetes >20 years