Emergency contraception Flashcards
(22 cards)
What is the use of emergency contraception?
Emergency contraception can be used after episodes of unprotected sexual intercourse (UPSI).
This includes situations where the contraceptive method is not protective, such as damaged condoms or multiple missed pills.
What are the 3 options for emergency contraception?
Levonorgestrel should be taken within 72 hours of UPSI
Ulipristal should be taken within 120 hours of UPSI
Copper coil can be inserted within 5 days of UPSI, or within 5 days of the estimated date of ovulation
What is the most effective emergency contraception?
Copper coil = most effective
It is also not affected by BMI, enzyme-inducing drugs or malabsorption, all of which can significantly reduce the effectiveness of oral methods.
The timeframe that oral emergency contraception is taken after UPSI is irrelevant. True/false?
False
The sooner it is taken, the more effective it is.
What should be checked and considered before starting emergency contraception?
Reassure about confidentiality
Sexually transmitted infections
Future contraception plans
Safeguarding, rape and abuse
Up to how long after UPSI can copper coil be used?
The copper coil can be used as an emergency contraception up to 5 days after unprotected intercourse, or within 5 days after the earliest estimated date of ovulation.
At what day of the cycle does ovulation typically occur?
Ovulation occurs 14 days before the end of the cycle, so if a woman’s shortest cycle length is 28 days, the earliest estimated date of ovulation is day 14.
It would be day 12 for a 26-day cycle, or day 16 for a 30-day cycle.
Copper coil is advised as first line for emergency contraception. True/false?
True
What is the most effective emergency contraception and how does it work?
The copper coil is toxic to the ovum and sperm, and also inhibits implantation.
It is the most effective emergency contraception, being over 99% effective.
What can insertion of copper coil/IUD increase the risk of?
May lead to pelvic inflammatory disease, particularly in women that are high risk of sexually transmitted infections.
What is levonorgestrel?
A type of progestogen. It works by preventing or delaying ovulation.
It is the same hormone found in the intrauterine system (hormonal coil).
It is not known to be harmful to the pregnancy if pregnancy does occur.
The combined pill or progestogen-only pill can be started immediately after taking levonorgestrel. True/false?
True
As an emergency contraception, how long after unprotected sexual intercourse can levonorgestrel pill be used?
Licensed for use up to 72 hours post sexual intercourse.
What are common side-effects of levonorgestrel pill?
Nausea and vomiting are common side effects. If vomiting occurs within 3 hours of taking the pill, the dose should be repeated.
Apart from nausea and vomiting, what other side-effects could present with levonorgestrel pill?
- Spotting and changes to the next menstrual period
- Diarrhoea
- Breast tenderness
- Dizziness
- Depressed mood
What is ulipristal?
Ulipristal acetate is a selective progesterone receptor modulator (SERM) that works by delaying ovulation.
The common brand name is EllaOne.
Levonorgestrel is more effective than ulipristal. True/false?
False
Ulipristal (EllaOne) is more effective than levonorgestrel.
How long after unprotected sexual intercourse can ulipristal be taken?
Licensed for up to 120 hours (5 days) after
Common side-effects of ulipristal acetate pill?
Nausea and vomiting
Other side-effects of ulipristal acetate pill?
- Spotting and changes to the next menstrual period
- Abdominal or pelvic pain
- Back pain
- Mood changes
- Headache
- Dizziness
- Breast tenderness
Basically same as side-effects for levonorgestrel
What are the 2 main restrictions for ulipristal acetate?
Breastfeeding should be avoided for 1 week after taking ulipristal (milk should be expressed and discarded) - unlike levonorgestrel which is safe.
Ulipristal should be avoided in patients with severe asthma
Why is the copper coil offered as a first line emergency contraception?
Can be inserted up to 5 day after unprotected sexual intercourse
A copper intra-uterine device is not known to be affected by body mass index (BMI), body-weight, or by other drugs.