Emergency Contraception Flashcards
What are the 3 methods of emergency contraception?
IUD
Levonorgestrel (morning after pill)
Ulipristal
When can the IUD be used and how effective is it?
IUD within 5 days of UPSI up until day 19 of the cycle.
Must ensure no risk of pregnancy which may have already implanted.
Most effective EC greater than 99%
When can levonorgestrel be used?
Most effective in 1st 24hrs (95%)
Licensed upto 72hrs after UPSI
Can be used off license up to 96hrs or even 120hrs (5 days)
More effective in 1st half of cycle before ovulation.
When can Ulipristal be used?
Can be used up to 120hrs but is only effective up until day 14 after this it cannot be used.
Similar efficacy as levonorgestrel (95%)
How does levonorgestrel work?
Inhibits ovulation if before day 14.
Afterwards effect is not understood, may effect sperm function.
No effect after fertilisation.
How does ulipristal work?
Progesterone receptor modulator.
Prevents/delays ovulation
Note reduces the effect of progesterone contraceptives therefore extra precautions need to be taken until next period.
Which medication effect the efficacy of emergency contraception medication?
Enzyme inducers:
- Epilepsy
- Rifampacin
- HIV medication
- St Johns wort
What side effects may you get from levonorgestrel?
Nausea
Vomiting (rare but need repeat dose if within 2hrs)
PV bleeding in 1st 7days post treatment
Menstrual disturbances in next cycle
What are the side effects of ulipristal?
Headache
Nausea
Abdo/back pain (period like)
