Emergency contraception: Separating fact from fiction

Abstract

Rates of unintended pregnancy and abortion are high, yet many doctors do not feel comfortable discussing emergency contraception with patients, even in cases of sexual assault. Since the approval of ulipristal acetate (ella) for emergency contraception, there has been even more confusion and controversy. This article reviews various emergency contraceptive options, their efficacy, and special considerations for use, and will attempt to clarify myths surrounding this topic.

Mifepristone 5 mg versus 10 mg for emergency contraception: double-blind randomized clinical trial

“…Regarding a possible reduced EC efficacy related to body weight >75–80 kg reported by other studies with levonorgestrel, 22 in the present study a significantly lower contraceptive efficacy for women weighing >75 kg was only found in the 5 mg mifepristone group. There were no significant differences for women weighing less or more than 75 kg in the 10 mg mifepristone group; this seems logical because as the mifepristone dose was slightly higher its efficacy was not weakened by a greater body weight.…”

“…There were no significant differences for women weighing less or more than 75 kg in the 10 mg mifepristone group; this seems logical because as the mifepristone dose was slightly higher its efficacy was not weakened by a greater body weight. The findings reported in other studies, 22 , 23 might be generalized to other drugs used for EC; many medication doses are calculated by body weight and probably this should be applied to all of them.…”

Are breast and pelvic exams necessary when prescribing hormonal contraception?

“…Although a levonorgestrel-based emergency contraceptive is available over the counter, ulipristal acetate is more effective, especially in women who are overweight. 15 A copper IUD placed within 5 days of intercourse is the most effective form of emergency contraception 15 but requires an office visit. This method is an option for most women but should be strongly considered for women at highest risk of pregnancy (previous unintended pregnancy, intercourse at midcycle, obesity).…”

Emergency Contraception

“…Amerikan verilerine göre gebeliklerin yarısı küretajla sonlandırılmakta ve küretaj yaptıran kadınların %54'ünün kontraseptif metot kullanırken gebe kaldığı görülmektedir 2 . CDC'nin verilerine göre 15-44 yaş arası kadınların %9,7'si acil kontraseptif metotları kullanmaktadır 3 .…”