Emergency hormonal contraception

Question 1

Use

Answer 1

• Unprotected sexual intercourse
• Contraceptive failure
• Advanced supply

Question 2

Referral

Answer 2

• > 5 days since UPSI
• Changes to period
• Severe liver dysfunction
• Interacting med: enzyme inducers (phenytoin, carbamazepine, rifampicin)

Question 3

Treatment: levonelle

Answer 3

16+

W/in 72H

Can take more than once in same cycle

Avoid: severe liver impairment, ectopic pregnancy, crohn’s disease

Breastfeeding: OK

Regular contraception: OK

Interaction: ciclosporin

Question 4

Treatment: ellaone

Answer 4

Under 16

W/in 120H

Cannot take more than once in same cycle

Avoid: severe liver impairment, asthma, steroids

Breastfeeding: not recommended for 1 week

Regular contraception: reduced efficacy, use condom until next period

Question 5

Advice

Answer 5

• Take ASAP
• Vomit w/in 3H, take another
• Use barrier method until next period
• Abn bleed at period: see GP
• Delayed period: >5 days late for levonelle, >7 days for ellaone