Contraception, Emergency

Key Features

• Information on clinics or individual clinicians providing emergency contraception in the United States may be obtained by calling 1-888-668-2528

• All victims of sexual assault should be offered emergency contraception

Treatment

Medication

• The following methods should be started within 120 h after unprotected coitus:

  • Levonorgestrel, 1.5 mg given orally in single dose

    • Has a 1–2% failure rate when taken within 72 hours

    • Available in the United States prepackaged as Plan B

  • If the levonorgestrel regimen is not available, a combination oral contraceptive containing ethinyl estradiol and levonorgestrel given twice in 12 hours may be used

    • Failure rate of these regimens is approximately 3%

    • Anti-nausea medication is often necessary

  • Ulipristal, 30 mg orally as a single dose

    • Has been shown to be more effective than levonorgestrel, especially when used between 72 and 120 hours, particularly among overweight women

    • It is available by prescription in the United States and western Europe

Intrauterine Devices

• Copper-bearing intrauterine devices (IUDs)

  • Prevents pregnancy when inserted within 5 days after one episode of unprotected midcycle coitus

  • Most effective available method for emergency contraception, with first cycle pregnancy rates of 0.1%