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Home Gynecology and Obstetrics

Emergency contraception

Dr.Galal Baligh by Dr.Galal Baligh
June 21, 2020
in Gynecology and Obstetrics
280 6
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Emergency contraception

Emergency contraception

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Contents hide
1 Emergency contraception definition:
2 Emergency contraception mechanism:
3 Emergency contraception available methods:
3.1 1. Postcoital douching:
3.2 2. Emergency contraception pills
3.3 3. Copper-bearing intrauterine devices (IUDs)
4 Emergency contraception PPT( power point presentations):
4.1 Emergency Contraception Mode of Action Animation video
4.2 The Science of ‘Plan B’ – Emergency Contraception video

♦ Also called, Post coital contraception.

Emergency contraception definition:

Contraceptive methods that, may prevent pregnancy after unprotected sexual intercourse.

* It is intended for emergency use following;

– Unprotected intercourse, e.g. rape or coerced sex.

– Failure of contraceptive, (e.g. torn condoms)

– Misuse of contraceptive (e.g. forgotten pills)

Emergency contraception mechanism:

– Emergency contraception is effective only in the first few days following intercourse before the ovum is released from the ovary and before the sperm fertilizes the ovum.

– Emergency contraceptive pills cannot interrupt an established pregnancy or harm a developing embryo, other wise it will be named abortifacient.

Emergency contraception available methods: 

1. Postcoital douching:

– Pharaonic method of contraception.

– Acetic acid 5% used as vaginal douch, immediately after intercourse.

– Can be dispensed by use of ECPs.

2. Emergency contraception pills

– WHO recommends levonorgestrel for emergency contraceptive pill use.

– Ideally, this progestogen-only method should be taken as a single dose (1.5 mg) within five days (120 hours) of unprotected intercourse.

– Alternatively, a woman can take the levonorgestrel in two doses (0.75 mg each; 12 hours apart).

– Another alternative protocol;

– Known as combined (Yuzpe) regimen.

– Each dose should contain at least 0.1 mg of EE and 0.5 mg of levonorgestrel,

– First dose must be taken as soon as possible and not later than 72 hours after unprotected intercourse.

– Repeat same dose 12 hours after first dose.

 Emergency contraception
Emergency contraception

* Mechanism;

– Preventing or delaying ovulation.

– Affect the cervical mucus and the ability of sperm to bind to the egg.

* Effectiveness;

 Emergency contraception
Emergency contraception

* Side effects;

more common with combined.

– Most common: Nausea and vomiting.

– Less common: Headache, dizziness, breast tenderness, irregular bleeding and spotting.

3. Copper-bearing intrauterine devices (IUDs)

– WHO recommends that a copper-bearing IUD, as an emergency contraceptive, be inserted within five days of unprotected intercourse.

– This may be an ideal emergency contraceptive for a woman who is hoping for an ongoing, highly effective contraceptive method.

* Mechanism;

– As emergency contraception, the copper-bearing IUD primarily prevents fertilization by causing a chemical change that damages sperm and ova before they can meet.

* Effectiveness;

– When inserted within five days of unprotected intercourse, a copper-bearing IUD is over 99% effective in preventing pregnancy.

– This is the most effective form of emergency contraception available.

– Once inserted, the woman can continue to use the IUD as an ongoing method of contraception, and she may choose to change to another contraceptive method in the future.

* Safety;

– A copper-bearing IUD is a very safe form of emergency contraception.

– The risks of infection, expulsion or perforation are low.

4. Mifepristone (Ru486)

– Not approved by WHO as emergency contraceptive method.

– Used mainly as an effective abortifacient

– Main mechanism is progesterone antagonist.

– Approved in Russia as emergency contraceptive method if used in low dose.

Emergency contraception PPT( power point presentations):

Emergency contraception videos:

Emergency Contraception Mode of Action Animation video

The fertile window is not easy to determine exactly, even if the length of the menstrual cycle is regular. This makes it difficult to pin-point the fertile days and assess the risk of becoming pregnant. As a consequence, it is always — during the entire cycle –absolutely necessary to use contraceptives in order to make sure sexual intercourse does not lead to unintended pregnancy. Please note that this video is for showcase purposes only. It does not inform nor does it attempt to explain the respective medical topic or mechanism of action in a comprehensive manner. CAST PHARMA is not responsible for the medical content of this film.

The Science of ‘Plan B’ – Emergency Contraception video

What happens when the condom breaks? Find out what’s behind “Plan B” – otherwise known as emergency contraception. Written and created by Mitchell Moffit (twitter @mitchellmoffit) and Gregory Brown (twitter @whalewatchmeplz). Created with the support of the Reproductive Health Technologies Project.

Tags: Contraception
Dr.Galal Baligh

Dr.Galal Baligh

OB-GYN Specialist

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