Emergency Contraception

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If EC given because of UPSI:

  • advise condom use for remainder of cycle. PT in 3 weeks advisable.
  • discuss ongoing contraception and provide method for future use
  • after LNG-EC use: consider ‘quick-starting’ (starting method at time of giving LNG-EC) ongoing hormonal contraception plus condoms for 7 days.
  • after UPA-EC use: start ongoing hormonal contraception after 5 days plus condoms for 7 days or at next period.

If EC given because hormonal contraception failure:

  • effectiveness of UPA-EC may be reduced. Avoid pill/patch/vaginal ring for 5 days after UPA-EC use before restarting method. Additional condom should be used for the 5 days plus a further 1 week after restarting the method. PT in 3 weeks advisable.
  • after LNG-EC, continue with the hormonal method with additional condom use for 1 week. PT in 3 weeks advisable.
  • effectiveness of UPA-EC may be reduced if progestogen taken in the previous 7 days. Avoid pill/patch/vaginal ring, etc.

If current or recent (past 4 weeks) enzyme-inducing drug use:    

  • copper-IUD most effective EC. If declined, give double dose (3mg) of LNG-EC*. Don’t use UPA-EC (SPC advice).

If breast feeding:      

  • avoid breast-feeding for 1 week after UPA-EC use. Can use LNG-EC.

If BMI > 26 Kg/M2 or weight >70Kg

  • may be reduced efficacy of LNG-ED.  Re-consider Copper IUD or Give UPA-EC or double dose LNG-EC
  • if BMI is greater than 30kg/mor weight greater than 85kg there may be reduced efficacy of UPA-EC. Reconsider Copper IUD.

* off-label

All EC methods
  • full consultation, including side-effects, action to be taken if vomiting within 2 to 3 hours (hormonal EC only)
  • provide written information
  • accurate documentation
  • consider STI testing
  • follow-up as appropriate.

The Faculty of Sexual & Reproductive Healthcare Guideline to Emergency Contraception

Editorial Information

Next review: 30 June 2016

Document Id: TAM373