What is emergency postcoital contraception?

Updated: Dec 10, 2018
  • Author: Frances E Casey, MD, MPH; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Answer

Answer

Emergency postcoital contraception is defined as the use of a drug or device to prevent pregnancy after unprotected sexual intercourse.  The expected risk of pregnancy after unprotected intercourse without emergency contraceptive treatment is 5.6%. [29]  Emergency contraception should never be utilized as a patient's primary method of contraception and all patients with user dependent methods or no method should be educated regarding the acquisition and use of emergency contraception..  

A variety of different methods of emergency contraception have been described. Emergency contraceptives available in the United States include, the Copper T380 IUD, emergency contraceptive pills (combined and progesterone-only), and a progesterone agonist/antagonist. Levonorgestrel (Plan B) and ulipristal acetate (Ella) are marketed as emergency contraceptives in the United States.

Candidates for emergency contraception include reproductive-aged women who have had unprotected sexual intercourse within 120 hours of presentation independent of the menstrual cycle. No known absolute contraindications to any of these methods have been described because exposure to the high dose of hormones is short lived. Exposure to the Yuzpe method (taking high doses of a combined birth control pill) may be contraindicated in patients with cardiovascular risk factors.

A study by Wilkinson et al analyzed the availability and access to emergency contraception for female adolescents since the FDA removed age restrictions to emergency contraception in 2013. The study reported that 83% of the 979 pharmacies in the study had emergency contraception available, however, 8.3% of the pharmacies, which were more often in low-income neighborhoods, said it was impossible to obtain emergency contraception under any circumstances. [30]


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