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Common questions on emergency and postcoital contraception

02 June 2020
Volume 31 · Issue 6


There are a number of key questions that must be asked when considering the method of emergency or postcoital contraception to use. Alison J Vaughan examines these when choosing from the three treatments available in the UK

Copper IUD (CU-IUD), Levonorgestrel (LNG-EC), Ulipristal Acetate Emergency Contraception (UPA-EC) are the three methods of emergency contraception (EC) available in the UK. CU-IUD is the most effective method and must be offered to all women requesting emergency contraception and that offer documented in the record. UPA is more effective than LNG but the efficacy of UPA can be affected by on-going contraception, so is not always the ideal method for all women (see Figure 1). A consultation for EC offers the opportunity to discuss on going contraception and sexual health. Comprehensive evidence-led guidance can be found in the EC clinical guideline, published by the Clinical Effectiveness Committee of Faculty of Sexual and Reproductive Healthcare (FSRH) in 2017.

Emergency contraception (EC) is defined as a contraceptive method that is administered after sexual intercourse but has its effects before implantation (considered to occur no earlier than five days after ovulation).

Though EC is no substitute for effective regular contraception, EC can provide a valuable option for women who are at risk of pregnancy following a problem with their usual contraceptive method or unprotected sexual intercourse (UPSI). There are three methods of EC available in the UK. This article describes the features of each and which is most appropriate in any given clinical situation.

A systemic review of safety data (Jatlaoui et al, 2015) for adverse events relating to use of EC in healthy women concludes that such events are rare.

Headache, nausea and dysmenorrhea have been reported in about 10% of users of Ulipristal Acetate Ella (UPA-EC)and Levonorgestrel (LNG-EC). It is important to advise the woman that if she vomits within three hours of taking oral EC, a repeat dose is required. After taking oral EC, menses can be delayed. However, if the period is delayed by more than seven days, a pregnancy test should be advised.

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