Emergency contraception

Question 1

How long is Levonorgestrel licensed for as emergency contraception? What dose is used>

Answer 1

72 hours - between 50-80% effective (95% if <24 hrs after UPSI)
1.5mg - can be used as many times as necessary
If vomiting occurs within 2 hours administer 2nd dose

Question 2

Side effects of emergency contraception?

Answer 2

Levonorgestrel - menstrual irregularities, delayed menstruation

Ulipristal - SPRMs inhibit action of progesterone - therefore they will inhibit action of most contraceptives - barrier protection must be used until next menstrual period
NB. CI in asthma controlled by glucocorticoids

Question 3

Patients with what condition are C.I. to use ullipristal?

Answer 3

Asthma controlled with glucocorticoids (e.g. beclometasone) - drug reaction

Question 4

Most effective emergency contraception?

Answer 4

Copper IUD - 99% effective regardless of when given
Can give up to 5 days after UPSi or the likely ovulation date (or if sex 2 days b4 likely ovulation date then can give 7 days after UPSI)

Question 5

Which emergency contraception can be given multiple time if necessary?

Answer 5

Levonorgestrel can be given multiple times within the same menstrual period

Question 6

Which emergency contraception makes regular contraception ineffective?

Answer 6

Ulipristal = selective progesterone receptor modulator - inhibits progesterone in other contraceptive methods - therefore use barrier contraception until next menstrual period and then resume regular contraception e.g. COCP

Question 7

Which emergency contraceptive should you give prophylactic Abx in patients with a high risk of having an STI?

Answer 7

IUD - should also swab for STI

Question 8

When can an IUD be inserted as emergency contraception?

Answer 8

5 days after UPSI or after likely date of ovulation

or if sex was 2 days before ovulation, can give 7 days after