What is Emergency Contraception?

Emergency contraception

Emergency contraception is a copper-bearing IUD that can be used to prevent pregnancy after sexual intercourse. It can prevent up to over 95% of pregnancies when taken within 5 days after intercourse. Though emergency contraception are recommended for use within 5 days, but they are more effective the sooner they are used after intercourse.

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How does emergency contraception work?

Emergency contraceptive pills work by preventing pregnancy or delaying ovulation. They do not induce an abortion. The prevent fertilization by causing a chemical change in sperm and egg before they meet. Though emergency contraception cannot disturb an established pregnancy or harm a developing embryo.

Who can use emergency contraception?

Emergency contraception can be used by any woman or girl of reproductive age to avoid an unwanted pregnancy. There are no complete medical contraindications to the use of emergency contraception. There are no age limits for the use of emergency contraception.

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What conditions can warrant the use of emergency contraception?

An advance supply of ECPs may be given to a woman so that she will have them available when needed and can take immediately after unprotected intercourse. Emergency contraception can be used in a number of situations after sexual intercourse. These include:

  • When no contraceptive has been used.
  • Sexual assault or rape when the woman was not protected by an effective contraceptive method.
  • When there is concern over improper use of contraceptive, such as:
  • 3 or more repeatedly missed combined oral contraceptive pills
  • condom breakage
  • more than one month late for the depot-medroxyprogesterone acetate (DMPA) progestogen-only injection
  • more than 3 hours late from the usual time of intake of the progestogen-only pill (minipill), or more than 27 hours after the previous pill
  • failed withdrawal
  • miscalculation of the abstinence period
  • more than 12 hours late from the usual time of intake of the desogestrel-containing pill (0.75 mg) or more than 36 hours after the previous pill;
  • more than 2 weeks late for the norethisterone enanthate (NET-EN) progestogen-only injection;
  • breakage, dislodgment, tearing, or early removal of a diaphragm or cervical cap
  • more than 7 days late for the combined injectable contraceptive (CIC)
  • failure of a spermicide tablet to melt before intercourse
  • failure to abstain or use a barrier method on the fertile days of the cycle
  • Expulsion of an intrauterine contraceptive device (IUD) or hormonal contraceptive implant.

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Methods of emergency contraception

There are four methods of emergency contraception:

  • ECPs containing UPA
  • ECPs containing LNG
  • Combined oral contraceptive pills
  • Copper-bearing intrauterine devices.

Emergency contraception pills (ECPs) and combined oral contraceptive pills (COCs)

WHO recommends any of the following drugs for emergency contraception:

  • ECPs with UPA, taken as a single dose of 30 mg;
  • ECPs with LNG taken as a single dose of 1.5 mg, or alternatively, LNG taken in 2 doses of 0.75 mg each, 12 hours apart.
  • COCs, taken as a split dose, one dose of 100 μg of ethinyl estradiol plus 0.50 mg of LNG, followed by a second dose of 100 μg of ethinyl estradiol plus 0.50 mg of LNG 12 hours later. (Yuzpe method).

Copper-bearing intrauterine devices

WHO recommends that when used as an emergency contraceptive method, the copper-bearing IUD be inserted within 5 days of unprotected intercourse. This method is appropriate for women who would like to start using a highly effective, long-acting, and reversible contraceptive method.

Effectiveness

When inserted within 120 hours of unprotected intercourse, a copper-bearing IUD is more than 99% potent in preventing pregnancy. This is the most effective form of emergency contraception available. A women can continue to use the IUD as an ongoing method of contraception once inserted, or may choose to change to another contraceptive method.

Safety

A copper-bearing IUD is a safe form of emergency contraception. It is estimated that there may be less than 2 cases of Pelvic Inflammatory Disease (PID) per 1000 users (3). (FP Global Handbook). The risks of expulsion or perforation are low.

 

Article source: www.who.int.com

Photo source: healthhub.com

 

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