EMERGENCY CONTRACEPTION Flashcards
Emergency contraception examples
copper IUD (most effective)
ulipristal 30mg - 120 hours (5 days)
levonorgestrel 1.5mg (72 hours)
Copper IUD
1st line - most effective
can be inserted up to 120 hrs (5 days)
can be inserted up to 5 days after the earliest estimated date of ovulation
Hormonal emergency contraceptives time scales
ulipristal 30mg - 120 hours (5 days)
levonorgestrel 1.5mg (72 hours)
Which EHC is more effective?
Ulipristal
vomiting and diarrhoea
2nd dose needed if this occurs in 3 hours
BMI and EHC
BMI could reduce the effectiveness (particularly levonorgestrel)
BMI over 26 or weight over 70kg = give ulipristal or double dose of levonorgestrel
Can EHC be used more than once in the same cycle?
Yes
but levonorgestrel there is increased risk of side effects
When to reinitiate regular contraception?
Levonorgestrel
- start regular immediately
- use condom until effective (2 days for POP, 7 days for combined)
Ulipristal
- wait 5 days before reinitiating
- use condoms during the 5 days and till treatment is effective
- if during week 1 in females taking regular CHC: CHC can be reinitiated immediately after. wear condom for 7 days
Levonorgestrel
- breast feeding: no delay
- caution in patient with malabsorption
- can cause breast tenderness, C+V, fatigue and haemorrhage
- avoid in severe liver impairment
Ulipristal
- breast feeding: 1 week delay
- caution is severe asthmatics controlled by glucocorticoids
- cycle irregularities, D+V, altered mood, dizziness
- avoid in severe liver impairment
Interactions
CYP inducers
Copper IUD MHRA
Risk of uterine perforation
report:
Severe pelvic pain after insertion
Sudden change in period
Pain during intercourse
unable to feel threads
Threads
Copper IUD, 2 threads come down
should be able to feel threads
need check up if you can’t
How often do you replace copper iUD
5 - 10 yrs
Levonorgestrel IUD
reduced pain/ bleeding side effects
replaced every 3-10 yrs
