Emergency contraception Flashcards
What is the risk of pregnancy following midcycle UPSI?
30%
What are the three methods of EC and how long after UPSI can they be used?
Levonelle- 72 hours
ellaOne- 120 hours
Copper IUD- 120 hours, or 120 hours after earliest predicted date of ovulation
What are the indications for EC?
UPSI following lack of contraceptive use or contraceptive failure
What is the most effective EC and should be offered to all women?
Cu-IUD
What aspects should be covered in the history during EC consultation? (3)
History of UPSI (how long since, contraceptive if any used)
Menstrual history
Obstetric and gynaecological history. as well as general medical
What should be considered during the consultation?
STI risk assessment/screening
Which drugs are particularly important to consider when prescribing LNG as EC?
Enzyme inducers such as rifampicin, anticonvulsants, st Johns wort
What is thought to be mechanism of Levonelle?
Early in the cycle it prevents ovulatio; later, mechanism is unclear
What is the advantage of using Cu-IUD?
Can be retained for ongoing contraception
What is the active agent in ellaOne and how does it work?
Ulipristal acetate (a selective progesterone receptor modulator) Inhibition or delay of ovulation
Other than enzyme inducers which types of drug might interfere with UPA?
Drugs which increase gastric pH such as proton pump inhibitors
How is STI risk assessed? (3)
Higher in women under 25; new sexual partner; more than one sexual partner in last year
