Emergency Contraception

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Emergency contraception
Mechanism
Progesterone-only method, one dose, 1.5mg within 120 hours of unprotected sex Alternatively, Levongestrel in two doses, 0.75 mg, q12h

Levonorgestrel ECPs prevent pregnancy by preventing or delaying ovulation. May also prevent fertilization of an eff by affecting the cervical mucus or decreasing the ability of sperm to bind to the egg **Note: levonorgestrel ECPs are NOT effective once process of implantation has begun, and will no cause abortion

Classification:
Emergency contraceptive pills (ECPs)
Copper T380 IUD – Most effective
Minipill emergency contraception method (MECM)
Progesterone agonist/antagonist

Efficacy
Most studies cite effectiveness rate of 55-94% for WHO-recommended regimen, true effectiveness rate ~75%. More effective the sooner after intercourse it is taken
MECM seems to have the same efficacy as ECP, but with less nausea and emesis
Copper T380 IUD can be inserted up to 7 days post-coitus; more effective than ECP or MECM, reducing risk of pregnancy post-coitus by >99%.

Indications
Reproductive-aged women who have had unprotected sexual intercourse within 72 hours of presentation independent of menstrual cycle For emergency use only.

Contraindications
No absolute contraindications – this is because exposure to high dose ofhormones is short-lived C/I in those who have confirmed pregnancy; however, if pregnant mother takes the pill, there is no harm to the fetus nor mother.

Advantages
Safe and do not cause abortion or harm future fertility.

Disadvantages
N/E, minor changes in menses, breast tenderness, fatigue, headache, abdominal pain, dizziness If treatment fails, may lead to ectopic pregnancy
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