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Contraception - emergency - Management
What are the adverse effects of oral levonorgestrel emergency contraception?
Adverse effects from oral levonorgestrel emergency contraception are uncommon and are seldom severe.
- In a large randomized controlled trial, the most common adverse effects reported by women taking oral levonorgestrel for emergency contraception were nausea (14%), fatigue (14%), and bleeding not related to menses (16%). More than half the women had menses within 2 days of the expected date. More of the remaining women in the levonorgestrel group tended to have menses earlier than expected [von Hertzen et al, 2002]. For details, see Table 1.
- Ectopic pregnancies have been reported after the use of emergency contraception, but there is no concern that the risk of ectopic pregnancy is increased by emergency contraception.
- A Cochrane review of 48 trials on emergency contraception in 33,110 women identified 5 cases of ectopic pregnancy (2 in women taking oral levonorgestrel and 3 in women taking mifepristone) [Cheng et al, 2004]; in the 4 trials which reported ectopic pregnancies there were a total of 133 pregnancies.
- As with any pregnancy, should the woman fall pregnant, the possibility of ectopic implantation should be considered [ABPI Medicines Compendium, 2004a; ABPI Medicines Compendium, 2004b; FFPRHC, 2006b].
Table 1. Adverse effects experienced within 7 days reported by women receiving 1500 micrograms levonorgestrel.
Adverse effect | Proportion of women reporting the effect (n = 1359) |
|---|
Nausea | 14% |
Vomiting | 1% |
Diarrhoea | 4% |
Fatigue | 14% |
Dizziness | 10% |
Headache | 10% |
Breast tenderness | 8% |
Lower abdominal pain | 14% |
Bleeding | 31% |
Delay of menses more than 7 days* | 5% |
* In 1334 women who were not pregnant. |
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