Emergency Contraception
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Patient Care

 Emergency Contraception

 Emergency Contraception

Emergency contraception

Key facts

Emergency contraception, or post-coital contraception, refers to methods of contraception that can be used to prevent pregnancy in the first few days after intercourse. It is intended for emergency use following unprotected intercourse, contraceptive failure or misuse (such as forgotten pills or torn condoms), rape or coerced sex.
 
Emergency contraception can prevent most pregnancies when taken after intercourse.
 
It is effective only in the first few days following intercourse before the ovum is released from the ovary and before the sperm fertilises the ovum. Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo.
 
Emergency contraceptive pills are for emergency use only and are not appropriate for regular use as an ongoing contraceptive method because of the higher possibility of failure compared with other contraceptives.
 
At the DSC Clinic, you will need to see the doctor to be prescribed with emergency contraceptive pills.
 

Who needs emergency contraception?

It is appropriate for any woman of reproductive age who needs to avoid an unwanted pregnancy.
 
Note: The use of emergency contraceptive pills does not protect against sexually transmitted infections or HIV infection.
 

In what situations should emergency contraception be used?

Emergency contraception can be used in a number of situations following sexual intercourse.
 
• When no contraceptive has been used.
• When there is a contraceptive failure or incorrect use.
• In cases of sexual assault when the woman was not protected by an effective contraceptive method.
 

Emergency contraception pills

At the DSC Clinic, a woman may be prescribed with the levonorgestrel tablet. A woman can take the levonorgestrel tablet in two doses (0.75mg each; 12 hours apart).
 
Effectiveness
Studies have shown that the WHO-recommended levonorgestrel regimen is 52–94% effective in preventing pregnancy.
 
Levonorgestrel is effective if taken within 72 hours (3 days) of unprotected intercourse and may also be used between 72 and 96 hours after unprotected intercourse, but efficacy decreases with time. [BNF 66]
 
Are there any side effects?
Levonorgestrel-alone emergency contraception pills are very safe and do not cause abortion or harm future fertility. Side-effects are uncommon and generally mild.
 
If vomiting occurs within 2 hours of taking levonorgestrel, a replacement dose should be given. [BNF 66]
 

Additional notes

Upon taking levonorgestrel:
 
• The next period may be early or late.
• A barrier method of contraception needs to be used until the next period.
• Seek medical attention promptly if any lower abdominal pain occurs because it could signify an ectopic pregnancy.
• Return to the clinic in 3 to 4 weeks if the subsequent menstrual bleed is abnormally light, heavy or brief, or is absent.
 

References

BNF66, Sept 2013 – Mar 2014
WHO, Fact sheet N°244, July 2012
Last updated on 24 Mar 2014