EHC Flashcards
what does ulipristal do
it inhibits or delays ovulation by postponing follicular rupture
how does ulipristal work
it suppress a surge in LH
when can ulipristal be used
within 5 days after UPSI or contraceptive failure
what does levonorgestrel do
it inhibits ovulation by delaying follicle rupture
how does levonorgestrel work
if taken prior to LH surge it inhibits ovulation for next 5 days until sperm from UPSI stops being viable
can ulipristal and levonorgestrel be used in the late follicular phase
ulipristal can and levonorgestrel can’t be
is levonorgestrel effective once process of implantation can occur
no
when is levonorgestrel licensed for use
within 3 days after UPSI or contraceptive failure
OR
between 3-4 days after UPSI or contraceptive failure but efficacy decreases with time
how long are sperm viable in female genital tract
for about 5 days after UPSI
how does Cu-IUD work
it inhibits fertilisation by its toxic effect on sperm and ova.
if fertilisation occurs the inflammatory reaction prevent implantation
when is the Cu-IUD licensed for use as EHC
within 5 days after UPSI or within 5 days of 1st date of estimated date of ovulation (WHICHEVER IS LATER)
which EHC is first line
ulipristal
what age can have ulipristal and levonorgestrel
patients over 13 years old
when is copper IUD given
- 120hrs after unprotected sex
- up to 5 days after predicted ovulation
-up to day 13 of extended EHC free
what weight can have C-IUD
any
what age can have C-IUD
any
who can’t have ulipristal according to flow chart
- progestogen used in last 5 days
- enzyme inducing drugs in last 28 days
- PPI in last 7 days, antacids in last 24 hrs
- current oral steroids
- breast feeding & not able to discard milk for 7days
when would you chose ulipristal
- UPSI within 10 days
- higher risk of pregnancy ie day 9-18 cycle
- over 70kg
- willing to wait 5 days before starting
when would you chose levonorgestrel
- UPSI within 72 hr
- lower risk of pregnancy after UPSI
- wishes to quick start EHC
what dose of levonorgestrel do you give if taking enzymes inducing drugs or high BMI/weight
3mg dose (2 tabs took together)
what bridging contraception do you use
desogestrel if appropriate
