References

Brache V, Cochon L, Duijkers IJM A prospective, randomized, pharmacodynamic study of quick-starting a desogestrel progestin-only pill following ulipristal acetate for emergency contraception. Hum Reprod. 2015; 30:2785-2793 https://doi.org/10.1093/humrep/dev241

Cheng L, Che Y, Gülmezoglu AM. Interventions for emergency contraception. Cochrane Database Syst Rev. 2012; 8 https://doi.org/10.1002/14651858.cd001324.pub4

Cleland K, Zhu H, Goldstuck N The efficacy of intrauterine devices for emergency contraception: a systematic review of 35 years of experience. Hum Reprod. 2012; 27:1994-2000

Díaz S Lactational amenorrhea and the recovery of ovulation and fertility in fully nursing Chilean women. Contraception. 1988; 38:53-67

Faculty of Sexual and Reproductive Healthcare. FSRH Clinical Guidance Emergency Contraception. 2017. http://www.fsrh.org (accessed 26 April 2020)

Faculty of Sexual and Reproductive Healthcare. Drug Interactions with Hormonal Contraception. 2017. http://www.fsrh.org/standards-and-guidance/documents/ceu-clinical-guidance-drug-interactions-with-hormonal/ (accessed 26 April 2020)

Faculty of Sexual and Reproductive Healthcare. Contraception for Women Aged Over 40. 2010. http://www.fsrh.org/documents/cec-ceu-guidance-womenover40-jul-2010/ (accessed 26 April 2020)

Faculty of Sexual and Reproductive Healthcare. United Kingdom Medical Eligibility Criteria Contraception. 2016. http://www.fsrh.org (accessed 26 April 2020)

FSRH CEU statement on antibiotic cover for urgent insertion of intrauterine contraception in women at high risk of STI. 2019. http://www.fsrh.org (accessed 26.4.20)

Glasier AF, Cameron ST, Fine PM Ulipristal acetate versus levonorgestrel for emergency contraception: a randomised non-inferiority trial and meta-analysis. Lancet. 2010; 375:555-562 https://doi.org/10.1016/s0140-6736(10)60101-8

Halpern V, Raymond EG, Lopez LM. Repeated use of pre- and postcoital hormonal contraception for prevention of pregnancy. Cochrane Database Syst Rev. 2014; 1 https://doi.org/10.1002/14651858.cd007595.pub3

Jatlaoui TC, Riley H, Curtis KM. Safety data for levonorgestrel, ulipristal acetate and Yuzpe regimens for emergency contraception. Contraception. 2015; 93:93-112 https://doi.org/10.1016/j.contraception.2015.11.001

Jesam C, Cochon L, Salvatierra AM A prospective, open-label, multicenter study to assess the pharmacodynamics and safety of repeated use of 30 mg ulipristal acetate. Contraception. 2016; 93:310-316 https://doi.org/10.1016/j.contraception.2015.12.015

Knight J Complete Guide to Fertility Awareness, 1st edn. Oxford: Routledge; 2017

Li HWR, Lo SST, Ng EHY Efficacy of ulipristal acetate for emergency contraception and its effect on the subsequent bleeding pattern when administered before or after ovulation. Hum Reprod. 2016; 31:1200-1207 https://doi.org/10.1093/humrep/dew055

Noé G, Croxatto HB, Salvatierra AM Contraceptive efficacy of emergency contraception with levonorgestrel given before or after ovulation. Contraception. 2011; 84:486-492 https://doi.org/10.1016/j.contraception.2009.12.015

Phillips SJ, Tepper NK, Kapp N Progestogen-only contraceptive use among breastfeeding women: a systematic review. Contraception. 2016; 94:226-252 https://doi.org/10.1016/j.contraception.2015.09.010

Polakow-Farkash S, Gilad O, Merlob P Levonorgestrel used for emergency contraception during lactation – a prospective observational cohort study on maternal and infant safety. J Matern Fetal Neonatal Med. 2013; 26:219-221 https://doi.org/10.3109/14767058.2012.722730

Rodriguez MI, Curtis KM, Gaffield ML Advance supply of emergency contraception: a systematic review. Contraception. 2013; 87:590-601 https://doi.org/10.1016/j.contraception.2012.09.011

Zhang L, Chen J, Wang Y Pregnancy outcome after levonorgestrel-only emergency contraception failure: a prospective cohort study. Hum Reprod. 2009; 24:1605-1611 https://doi.org/10.1093/humrep/dep076

Common questions on emergency and postcoital contraception

02 June 2020
Volume 31 · Issue 6

Abstract

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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