Key Recommendations

Individuals should meet the following recommendations as part of a healthy eating pattern and while staying within their caloric needs. Recommended daily amounts listed below are based on an adult diet of 2,000 calories per day.

• Fruits (2 cups)—Eat a variety of fruit. Choose whole or cut-up fruits more than fruit juice.

• Vegetables (2.5 cups)—Eat a variety of vegetables, especially dark-green, red, and orange vegetables and beans and peas.

• Grains (6 oz)* *—Consume at least one half of all grains as whole grains. Increase whole-grain intake by replacing refined grains with whole grains.

• Dairy (3 cups)—Increase intake of fat-free or low-fat milk and dairy prod­ucts, such as milk, yogurt, cheese, or fortified soy beverages¹.

• Protein Foods (5.5 oz)—Choose a variety of protein foods, which include seafood, lean meat, poultry, eggs, beans and peas, soy products, and unsalted nuts and seeds. Increase the amount and variety of seafood con­sumed by choosing seafood in place of some meat and poultry. Replace protein foods that are higher in solid fats with choices that are lower in fats and calories.

• Oils (6 teaspoons)—Use oils to replace solid fats where possible.

The following is recommended if patch application or detachment* * or ring insertion or reinsertion¹ is delayed for less than 48 hours:

• Apply patch or insert ring as soon as possible. (If detachment of a patch occurred less than 24 hours since the patch was applied, try to reapply the patch or replace with a new patch.)

• Keep the same patch change day, or keep the ring in until the scheduled removal day.

• No additional contraceptive protection is needed.

• Emergency contraception is not usually needed but can be considered if delayed patch application or detachment or ring insertion or reinsertion occurred earlier in the cycle or in the last week of the previous cycle.

The following is recommended if patch application or detachment* or ring insertion or reinsertion¹ is delayed for 48 hours or longer:

• Apply a new patch or insert a new ring as soon as possible.

• Keep the same patch change day or keep the ring in until the scheduled ring removal day.

• Use back-up contraception (eg, condoms) or avoid sexual intercourse until a patch or ring has been worn for 7 consecutive days.

• If the delayed patch application or detachment or ring removal occurred in the third week of use

—omit the hormone-free week by finishing the third week of use (keep­ing the same patch change day) and starting a new patch or ring immediately.

— if unable to start a new patch or ring immediately, use back-up contra­ception (eg, condoms) or avoid sexual intercourse until a new patch or ring has been worn for 7 consecutive days.

— emergency contraception should be considered if the delayed patch application or detachment of the patch or ring insertion or reinsertion occurred within the first week of use and unprotected sexual inter­course occurred in the previous 5 days.

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*If detachment of the patch takes place but the woman is unsure when it occurred, consider the patch to have been detached for at least 48 hours since a patch should have been applied or reattached.

TIf removal of the ring takes place but the woman is unsure of how long the ring has been removed, consider the ring to have been removed for at least 48 hours since a ring should have been inserted or reinserted.

Modified from U.S. Selected Practice Recommendations for Contraceptive Use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. MMWR Recomm Rep 2013;62:1-60.