Emergency Contraception

Question 1

Emerg ency Contraception Timings

Answer 1

1. Levenogestrel (within 72 hrs)
2. Ulipristil (within 120 hrs)
3. Cu-IUD (within 120 hrs)

Question 2

Levenorgestrel (Levonelle)

Answer 2

Within 72 hrs of UPSI (95% effective in first 24 hr, 84% at 48)

Stops ovulation, inhibits implantation

Safe and well tolerated

If vomit within 2hrs repeat dose

can be used more than once in cycle

Question 3

Ulipristal (EllaOne)

Answer 3

• Must be within 120 hrs UPSI (95% effective)
• Progesterone receptor modulator inhbits ovulation
• NOT used with levenorgestral
• If patient normally uses hormonal contraception restart after 5d, use barrier meantime
• Caution if severe asthma
• Insuf. evidence for more than one per cycle
• if vomit within 3 hours repeat dose
• NB. >70kg or BMI >26 (EllaOne recom., if Levonelle give double dose and advise start contraception immediately)

Question 4

Levonelle Dose

Answer 4

>70 kg or BMI >26: 3mg

normal dose: 1.5

Question 5

Copper IUD

Answer 5

within 120 hrs

If >5d since UPSI fit IUD up to 5d post ovulation

Spermicidal and prevents implantation

Prophylactic abx if at risk of STI

Long term contraception if left

Question 6

Advice when giving emergency contraception

Answer 6

Offer STI screen

Recommend take prg test if period late

Cost of morning after pill: £25, free from GUM/GP

SE (not IUD): N+V, headache, breast tenderness, abnormal menstrual bleeding