Emergency contraception pills

ECPs

1. Emergency contraception pills FAMILY PLANING BSC MW 3 ELISHA JR 8/20/2016 ELISHA JR 1

2. Introduction. Emergency contraception- refers to methods of contraception that can be used to prevent pregnancy in the first few days after intercourse.[within 5 days] It is intended for emergency use following unprotected intercourse, contraceptive failure or misuse (such as forgotten pills or torn condoms), rape or coerced sex. 8/20/2016 ELISHA JR 2

3. 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. 8/20/2016 ELISHA JR 3

4. In what situations should emergency contraception be used? When no contraceptive has been used. B. In cases of sexual assault when the woman was not protected by an effective contraceptive method. 8/20/2016 ELISHA JR 4

5. C. When there is a contraceptive failure or incorrect use, including : condom breakage, slippage, or incorrect use; three or more consecutively missed combined oral contraceptive pills; dislodgment, delay in placing, or early removal of a contraceptive hormonal ring or skin patch; dislodgment, breakage, tearing, or early removal of a diaphragm or cervical cap; 8/20/2016 ELISHA JR 5

6. failed withdrawal (e.g. ejaculation in the vagina or on external genitalia); failure of a spermicide tablet to melt before intercourse; Miscalculation of the safe period when using a calender method. 8/20/2016 ELISHA JR 6

7. Emergency contraception pills What Are Emergency Contraceptive Pills ? ECPs are hormonal methods of contraception used to prevent pregnancy following an unprotected act of sexual intercourse. Emergency contraceptive pills (ECPs) are sometimes called “ morning after ” pills or postcoital contraceptives 8/20/2016 ELISHA JR 7

8. What Pills Can Be Used as Emergency Contraceptive Pills? Pills that contain a progestin alone, or a progestin and an estrogen together—hormones like the natural hormones progesterone and estrogen in a woman’s body . 8/20/2016 ELISHA JR 8

9. ECP regimens Two progestogen-only- levonorgestrel regimens are packaged and labeled specifically for emergency contraception, 1 tablet levonorgestrel taken as a single dose (1.5 mg) within five days (120 hours) of unprotected intercourse. Or 2 tablets of 0.75 mg levonorgestrel to be taken 12 hours apart. The evidence shows that it is best if both pills are taken at the same time. 8/20/2016 ELISHA JR 9

10. Combined pills Combined oestrogen / progestogen pills, containing ethinyl oestradiol and levonorgestrel , can be taken in a regimen known as the “ Yuzpe method” When pills containing 50 μg ethinyl oestradiol and 0.25 mg levonorgestrel are available: • 2 pills should be taken as the first dose as soon as convenient but no later than 120 hours after unprotected intercourse 8/20/2016 ELISHA JR 10

11. These should be followed by another 2 pills 12 hours later. When only pills containing 30 μg ethinyl oestradiol and 0.15 mg levonorgestrel are available: • 4 pills should be taken as the first dose as soon as convenient but no later than 120 hours after unprotected intercourse. These should be followed by another 4 pills 12 hours later. 8/20/2016 ELISHA JR 11

12. Mode of action Hormonal emergency contraception achieves its contraceptive effect by several mechanisms depending on the time in a woman’s cycle it is taken. It can inhibit or delay ovulation and may also interact with ovum and sperm transport, and fertilization. No evidence that emergency contraception can cause changes in the endometrium that would be sufficient to interfere with implantation 8/20/2016 ELISHA JR 12

13. There is no evidence that hormonal emergency contraception dislodges the embryo after implantation has occurred. Hormonal emergency contraception does not cause an abortion 8/20/2016 ELISHA JR 13

14. Health Benefits Help protect against risks of pregnancy Do not cause abortion. Do not cause birth defects if pregnancy occurs. Are not dangerous to a woman’s health. Do not promote sexual risk-taking. Do not make women infertile . 8/20/2016 ELISHA JR 14

15. Medical eligibility criteria Emergency contraceptive pills prevent pregnancy. They should not be given to a woman who already has a confirmed pregnancy. However, if a woman inadvertently takes the pills after she becomes pregnant, the available evidence suggests that the pills will not harm either the mother or her fetus. 8/20/2016 ELISHA JR 15

16. Emergency contraceptive pills are for emergency use only and are not appropriate for regular use as an ongoing contraceptive method because of the higher possibility of failure compared with non-emergency contraceptives. There is no need for a physical examination before providing it . 8/20/2016 ELISHA JR 16

17. Efficacy The efficacy is better the sooner the method is used after sex. 8/20/2016 ELISHA JR 17

18. Common side Effects Changes in bleeding patterns including : – Slight irregular bleeding for 1–2 days after taking ECPs – Monthly bleeding that starts earlier or later than expected Abdominal pain Feeling sick Tiredness 8/20/2016 ELISHA JR 18

19. Less common side effects include; Nausea Headaches Breast tenderness Dizziness Vomiting 8/20/2016 ELISHA JR 19

20. Who is this method good for? Safe for all women —even women who cannot use ongoing hormonal contraceptive methods 8/20/2016 ELISHA JR 20

21. References Family Planning a global handbook for provider by J Hopkins www.who.int/mediacentre/factsheets/fs244/en/ [retrieved on 6/12/2015 at 9AM] 8/20/2016 ELISHA JR 21