Emergency Contraception

Question 1

name the emergency contraceptive pills available?

Answer 1

• levonorgestrel
• ulipristal (EllaOne)

Question 2

what is the mode of action of levonorgestrel?

Answer 2

not fully understood
* stop ovulation
* inhibit implantation

Question 3

what is the time frame for taking levonorgestrel?

Answer 3

must be taken within 72 hours of unprotected sexual intercourse

efficacy decreases with time and therefore should be taken ASAP

Question 4

what dose of levonorgestrol is given?

Answer 4

1.5mg
* dose should be doubled for those with a BMI >26 or weight over 70kg

Question 5

what should you counsel women about before giving levonorgestrel?

Answer 5

• vomiting within 3 hours = repeat dose
• can be used more than once in a menstrual cycle
• hormonal contraception can be started immediately following levonorgestrel

Question 6

what is the mode of action of ulipristal (EllaOne)?

Answer 6

• selective progesterone receptor modulator
• inhibits ovulation

Question 7

what dose of ulipristal is given?

Answer 7

30mg

Question 8

what is the time frame for taking ulipristal?

Answer 8

**120 hours **after unprotected intercourse

Question 9

what should you counsel women about before taking ulipristal?

Answer 9

• may reduce the effectiveness of hormonal contraception –> restart/start** 5 days** post ulipristal
• caution in patients with severe asthma
• can be used more than once in the same cycle
• delay breastfeeding by 7 days following ulipristal

Question 10

what is the most effective emergency contraception?

Answer 10

copper IUD

Question 11

what time frame can copper IUD be inserted for emergency contraception?

Answer 11

• within **5 days ** of unprotected sex
• > 5 days = fitted 0-5 days after ovulation