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Contraception - emergency - Management
What method should I recommend for emergency contraception?
- Options include the levonorgestrel pill, the ulipristal acetate pill, or a copper intrauterine device (IUD).
- The choice of emergency contraception should be made by the woman.
- Levonorgestrel is licensed for use up to 72 hours (3 days). Inform the woman that the effectiveness of levonorgestrel effectiveness diminishes rapidly with delay in using it, and that pharmacists will not provide levonorgestrel without a prescription if the time since unprotected sexual intercourse is more than 72 hours.
- Ulipristal acetate is licenced for use up to 120 hours (5 days) after unprotected sexual intercourse. Effectiveness is maintained over time. Safety and efficacy of ulipristal acetate has only been established in women 18 years and older and it is only available on prescription.
- An IUD containing at least 380 mm2 of copper is the most effective method. It can be inserted up to 5 days after unprotected intercourse or, if the timing of ovulation can be estimated, up to 5 days after ovulation. Ideally, an emergency IUD should be fitted at first presentation, but insertion can be offered later. In this case, levonorgestrel emergency contraception should be given in the interim.
In depth
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