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 Overview/Lessons Learned | Contraceptive Methods | Key Issues
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Emergency Contraception

Emergency contraceptives are methods women can use to prevent pregnancy after unprotected intercourse (such as when a contraceptive fails or when sex occurs without contraception). Two types of emergency contraception are available: emergency contraceptive pills (ECPs) and emergency copper-bearing IUD insertion. ECPs can be used up to 72 hours (three days) after unprotected intercourse. Emergency IUD insertion can be used up to five days after unprotected intercourse. Both methods are safe and effective if proper service delivery guidelines are followed. The only condition restricting use of ECPs is established pregnancy. Conditions restricting regular use of IUDs also apply to their emergency use.

Essential Information For Clients

Women considering using ECPs have the right to essential information about the method. This includes information about how to take the method, descriptions of various side effects that might be experienced and guidance on when to contact a health care provider.

Taking ECPs: For maximum effectiveness, the first ECP dose should be administered as soon as possible within 72 hours (3 days) of unprotected intercourse.The second dose must be taken 12 hours later.

While several specially packaged products (including PC4, Postinor-2, Preven, and Plan B) have become available in some countries, it is also common practice to use special elevated doses of regular oral contraceptives. Dedicated ECP products, combined oral contraceptive pills, and progestogen-only contraceptive pills can be used for emergency contraception as described below:


Brand/Manufacturer


Pills per Dose*


Ethinyl Estradiol per Dose (g)


Levonorgestrel per Dose (mg)**

Dedicated Products

Preven (Gynetics)

2 blue pills

100

0.50

Plan B (WCC)

1 white pill

0

0.75

Oral Contraceptive Pills

Ovral (Wyeth-Ayerst)

2 white pills

100

0.50

Alesse (Wyeth-Ayerst)

5 pink pills

100

0.50

Levlite (Berlex)

5 pink pills

100

0.50

Nordette (Wyeth-Ayerst)

4 light- orange pills

120

0.60

Levlen (Berlex)

4 light- orange pills

120

0.60

Levora (Watson)

4 white pills

120

0.60

Lo/Ovral (Wyeth-Ayerst)

4 white pills

120

0.60

Triphasil (Wyeth-Ayerst)

4 yellow pills

120

0.50

Tri-Levlen (Berlex)

4 yellow pills

120

0.50

Trivora (Watson)

4 pink pills

120

0.50

Ovrette (Wyeth-Ayerst)

20 yellow pills

0

0.75

Side effects: The main side effects of ECP treatment are nausea and vomiting. Side effects are more common with combined ECPs regimens than with progestogen-only ECP regimens. About half of women taking combined ECPs experience nausea and up to one fifth vomit after the first or second dose; rates of nausea and vomiting are 20 percent and 5 percent respectively in women using progestogen-only regimens. These side effects generally do not last more than 24 hours and may be reduced in some women by providing anti-nausea medication before ECP treatment.

Effectiveness

Treatment fails in about 2% of women per use (Note: this failure rate cannot be compared directly to annual failure rates of other methods because it is for a single use)

Age limitations

No restrictions on use

Parity limitations

No restrictions on use for nulliparous or parous women

Mode of action

Primarily by inhibiting ovulation; treatment also may cause changes in the endometrium

Effect on STD risk

Not protective

Drug interaction

None known; given the short duration of treatment it is unlikely that drug interactions that affect COC use also affect ECP use

Duration of use

Intended for occasional "emergency" use; other methods used correctly and consistently provide more effective ongoing contraceptive protection

Return to fertility

Immediate; therefore, it is critical that women begin using another form of contraception immediately after use

Return to Contraceptive Method List

Adapted from Journal of the American Medical Women's Association EC Supplement 1998, revised version of the table (page 213).

* The treatment schedule is one dose within 72 hours after unprotected intercourse, and a second dose 12 hours later.
** The progestin in Ovral, Lo/Ovral, and Ovrette is norgestrel, which contains two isomers, only one of which (levonorgestrel) is bioactive; the amount of norgestrel in each dose is twice the amount of levonorgestrel.


Copyright 1997-2000, PATH.

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