- EC can be utilized when you look at the following circumstances: unprotected sex, issues about feasible contraceptive failure, wrong usage of contraceptives, and sexual assault if without contraception protection.
- Types of crisis contraception will be the copper-bearing intrauterine devices (IUDs) in addition to emergency contraceptive pills (ECPs).
- A copper-bearing IUD could be the many form that is effective of contraception available.
- The crisis contraceptive capsule regimens suggested by that are ulipristal acetate, levonorgestrel, or combined dental contraceptives (COCs) composed of ethinyl estradiol plus levonorgestrel.
What exactly is crisis contraception?
Emergency contraception identifies ways of contraception which you can use to stop maternity after sexual activity. These are suitable for used in 5 days but are more efficient the earlier they’ve been utilized following the work of sexual intercourse.
Mode of action
Emergency contraceptive pills prevent maternity by preventing or ovulation that is delaying they don’t cause an abortion. The copper-bearing IUD stops fertilization by causing a chemical improvement in egg and sperm before they meet. Crisis contraception cannot interrupt a well established pregnancy or damage a developing embryo.
Who is able to make use of crisis contraception?
Any girl or woman of reproductive age might need crisis contraception in order to prevent a pregnancy that is unwanted. There are not any absolute contraindications that are medical the usage of crisis contraception. You will find no age limits for the utilization of emergency contraception. Eligibility requirements for basic usage of a copper IUD also make an application for usage of a copper IUD for emergency purposes.
With what situations can emergency contraception be properly used?
Emergency contraception can be utilized in many circumstances following sexual activity. These generally include:
- Whenever no contraceptive has been utilized.
- Intimate attack once the girl had not been protected by a powerful method that is contraceptive.
- If you have concern of feasible contraceptive failure, from incorrect or wrong use, such as for instance:
- Condom breakage, slippage, or use that is incorrect
- 3 or higher consecutively missed combined oral contraceptive pills;
- Significantly more than 3 hours later through the typical time of consumption of this progestogen-only capsule (minipill), or even more than 27 hours following the past tablet;
- Significantly more than 12 hours late through the typical time of consumption for the desogestrel-containing tablet (0.75 mg) or higher than 36 hours following the past product;
- Significantly more than two weeks later for the norethisterone enanthate (NET-EN) progestogen-only injection;
- A lot more than 4 weeks belated for the depot-medroxyprogesterone acetate (DMPA) progestogen-only injection;
- A lot more than seven days later for the combined injectable contraceptive (CIC);
- Dislodgment, breakage, tearing, or very very very early elimination of a diaphragm or cap that is cervical
- Unsuccessful withdrawal ( ag e.g. Ejaculation into the www.japanese-dating.org vagina or on outside genitalia);
- Failure of a spermicide film or tablet to melt before sex;
- Miscalculation for the abstinence period, or failure to abstain or make use of a barrier method regarding the fertile times of the period whenever fertility that is using based practices; or
- Expulsion of a intrauterine contraceptive device (IUD) or hormonal implant that is contraceptive.
An advance way to obtain ECPs might be directed at a female to make certain them available when needed and can take as soon as possible after unprotected intercourse that she will have.
Moving to contraception that is regular
After utilization of ECPs, ladies or girls may resume or start a method that is regular of. No additional contraceptive protection is needed if a copper IUD is used for emergency contraception.
After management of ECPs with levonorgestrel (LNG) or combined dental contraceptive pills (COCs), ladies or girls may resume their contraceptive technique, or start any contraceptive method straight away, including a copper-bearing IUD.
After utilization of ECPs with ulipristal acetate (UPA), females or girls may resume or begin any progestogen method that is containing combined hormone contraception or progestogen only contraceptives) regarding the 6th time after using UPA. They could have an LNG-IUD placed immediately if it could be determined they’re not pregnant. The copper can be had by them IUD inserted straight away.
Types of crisis contraception
The 4 ways of crisis contraception are:
- ECPs containing UPA
- ECPs containing LNG
- Combined dental contraceptive pills
- Copper-bearing intrauterine products.
Crisis contraception pills (ECPs) and combined oral contraceptive pills (COCs)
Whom suggests some of the drugs that are following emergency contraception:
- ECPs with UPA, taken being a dose that is single of mg;
- ECPs with LNG taken being a solitary dosage of 1.5 mg, or alternatively, LNG drawn in 2 doses of 0.75 mg each, 12 hours aside.
- COCs, taken as being a split dosage, one dosage of 100 ?g of ethinyl estradiol plus 0.50 mg of LNG, accompanied by a 2nd dosage of 100 ?g of ethinyl estradiol plus 0.50 mg of LNG 12 hours later on. (Yuzpe technique)
Effectiveness
A meta-analysis of two studies revealed that ladies who utilized ECPs with UPA had a maternity rate of 1.2%. Research indicates that ECPs with LNG had a maternity price of 1.2per cent to 2.1per cent (1) (2).
Preferably, ECPs with UPA, ECPs with LNG or COCs should be used as early as feasible after unprotected sex, within 120 hours. ECPs with UPA are far more effective between 72–120 hours after unprotected sexual intercourse than other ECPs.
Unwanted effects through the usage of ECPs act like those of oral contraceptive pills, such as for instance sickness and sickness, small irregular genital bleeding, and weakness. Negative effects aren’t typical, these are generally mild, and certainly will typically resolve without further medicines.
The dose should be repeated if vomiting occurs within 2 hours of taking a dose. ECPs with LNG or with UPA are better COCs simply beresult they cause less vomiting and nausea. Routine usage of anti-emetics before using ECPs isn’t suggested.
Drugs utilized for crisis contraception usually do not damage future fertility. There’s no wait into the come back to fertility after using ECPs.
Healthcare eligibility requirements
There are not any limitations when it comes to eligibility that is medical of may use ECPs.
Some ladies, but, utilize ECPs over over over repeatedly for almost any associated with reasons stated above, or as their method that is main of. This kind of situations, further counselling should be provided on which other and much more regular contraceptive choices could be appropriate and more effective.
Frequent and repeated ECP use are harmful for females with conditions categorized as medical eligibility criteria (MEC) category 2, 3, or 4 for combined hormone contraception or Progestin-only contraceptives (POC). Regular usage of crisis contraception may result in increased side-effects, such as for example menstrual problems, although their duplicated use poses no understood health problems.
Emergency contraceptive pills had been discovered become less effective in obese ladies (whose human body mass index is much more than 30 kg/m2), but there aren’t any security issues. Overweight ladies really should not be rejected usage of crisis contraception whenever they want it.
Counselling for usage of crisis contraceptive pills will include choices for utilizing regular contraception and suggestions about simple tips to utilize practices properly in case there is recognized technique failure.
Copper-bearing intrauterine products
WHO suggests that a copper-bearing IUD, when utilized as a crisis contraceptive technique, be placed within 5 times of unprotected sex. This technique is specially suitable for ladies who would like to begin using a powerful, long-acting, and reversible contraceptive technique.
Effectiveness
When placed within 120 hours of unprotected sex, a copper-bearing IUD is significantly more than 99% effective in preventing maternity. Here is the many effective kind of crisis contraception available. Once placed, ladies can continue steadily to utilize the IUD as a continuous way of contraception, or might want to alter to another method that is contraceptive.
A copper-bearing IUD is really a form that is safe of contraception. It’s estimated that there might be lower than 2 situations of Pelvic Inflammatory Disease (PID) per 1000 users (3). (FP Global Handbook). The potential risks of perforation or expulsion are low.
Health eligibility requirements
Eligibility requirements for basic utilization of a copper IUD also make an application for usage of a copper IUD for crisis purposes. Ladies with a disorder categorized as MEC category three or four (for instance, with present PID, puerperal sepsis, unexplained genital bleeding, cervical cancer tumors, or serious thrombocytopenia) for the copper IUD must not work with a copper IUD for crisis purposes. In addition, a copper-bearing IUD shouldn’t be placed for crisis contraception after sexual attack as the girl can be at high chance of an intimately transmitted disease such as for instance chlamydia and gonorrhoea. A copper-bearing IUD shouldn’t be utilized as crisis contraception whenever a lady is expecting.
The whom healthcare eligibility requirements for contraceptive usage states that IUD insertion may further raise the danger of PID among ladies at increased risk of sexually sent infections (STIs), although limited proof shows that this danger if low. Present algorithms for determining increased threat of STIs have bad value that is predictive.
