Emergency Contraception

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Emergency contraception (EC) reduces the risk of an unintended pregnancy after unprotected sexual intercourse, if no contraception was used or when contraception may not have worked properly. This may occur after a broken or slipped condom, or a forgotten contraceptive pill. There are three recommended methods of emergency contraception:

  1. A single dose of progesterone (1.5mg levonorgestrel - LNG) licensed for use up to 72 hours (3 days) after unprotected sex and estimated to prevent ~ 85% of expected pregnancies. It is most effective if taken within 24 hours (1 day) of unprotected sex, but can be taken up to 96 hours (4 days) later. It is available over the counter at all pharmacies without prescription under the brand names Norlevo-1®, Postinor-1® and Levonelle-1®.
  2. A single dose of an antiprogesterone (30mg ulipristol acetate - UPA) licensed for use up to 120 hours (5 days) after unprotected sex. It is available over the counter without a prescription under the brand name EllaOne® .It is more effective but more expensive than LNG EC. 
  3. Copper IUD inserted within 5 days of unprotected sex, or no more than 5 days after ovulation if sex occurred earlier in the cycle. This is the most effective method but has to be inserted by a trained IUD inserter and is more expensive.

WHAT IS THE RISK OF PREGNANCY?

After a single episode of unprotected sex it is estimated that 8% of women will conceive. This is reduced to 1% after LNG EC, 0.5% after UPA, and 0.1% after a copper IUD is inserted. All methods are more effective if taken as soon as possible after unprotected sex. LNG EC and UPA should not be taken together as they counteract each other.

ARE THERE ANY SAFETY ISSUES?

LNG EC and UPA prevent or delay ovulation and do not cause abortion or harm a pregnancy if inadvertently taken when pregnant. Both methods are safe and do not affect long term fertility.

SIDE EFFECTS:

Side effects are usually mild and short lived. There is a small chance of nausea, bloating, dysmenorrhoea, dizziness, breast tenderness and headache.

WHEN TO EXPECT YOUR NEXT PERIOD:

Your next period will usually come on time, but EC can result in an early or delayed bleed. Some women have a light bleed in the week after EC that is not related to a period.
A follow up pregnancy test is recommended at 3-4 weeks if the next period is unusually late or abnormally light or unusual in any way.

ONGOING CONTRACEPTION:

A copper IUD has the advantage of providing ongoing effective contraception.
Neither LNG EC or UPA provide ongoing contraception.
LNG EC can be repeated if unprotected sex occurs again within the same menstrual cycle, it is not known if UPA can be repeated.
Hormonal contraception can be started or continued on the same day as LNG EC is taken with no loss of efficacy of either method. However, hormonal contraception has to be stopped or delayed for 5 days after taking UPA as they may counteract each other and reduce efficacy.

For more information 
Call Melbourne Sexual Health Centre
9341 6200 or 1800 032 017

Ask for the information and results line if you have any questions and/or concerns about Emergency Contraception.

DISCLAIMER:
This fact sheet is designed to provide you with information on Emergency Contraception.It is not intended to replace the need for a consultation with your doctor. All clients are strongly advised to check with their doctor about any specific questions or concerns they may have. Every effort has been taken to ensure that the information in this pamphlet is correct at the time of printing.
Last Updated October 2017