Society of Family Planning Clinical Recommendation: Emergency contraception

Salcedo, Jennifer; Cleland, Kelly; Bartz, Deborah; Thompson, Ivana

doi:10.1016/j.contraception.2023.109958

Cited by 24 publications

(38 citation statements)

References 105 publications

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“…In combined analyses of two randomized trials comparing ulipristal acetate with levonorgestrel, the odds of pregnancy after ulipristal acetate were 42% lower when taken up to 72 hours after unprotected intercourse compared with levonorgestrel. 6 These differences are important and should be communicated to our patients.…”

Section: How Does Emergency Contraception Work?mentioning

confidence: 93%

“…4,5 The Society of Family Planning released new clinical guidelines related to emergency contraception in February 2023. 6 These guidelines discuss commonly used emergency contraception methods, including oral agents such as ulipristal acetate and oral levonorgestrel, as well as the copper IUD. In addition, the new guideline includes the progestin IUD as an option for emergency contraception.…”

mentioning

confidence: 99%

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The Levonorgestrel-Releasing Intrauterine Device as Emergency Contraception

Ramanadhan,

Jensen

2023

Obstetrics &Amp; Gynecology

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Emergency contraception methods that also deliver ongoing contraception provide the most effective options for individuals hoping to prevent pregnancy after unprotected intercourse. Although the copper intrauterine device (IUD) provides the most effective option for emergency contraception because the device prevents pregnancy when placed before implantation and offers long-acting contraception, uptake by patients has been limited. Recently, the Society of Family Planning issued new guidance recommending the levonorgestrel IUD (LNG-IUD) as an emergency contraception option along with the copper IUD. Here, we review evidence related to this recommendation and conclude that the available data do not support use of the LNG-IUD for emergency contraception. We discuss the mechanisms of action of emergency contraception methods and how these concepts interface with the current political and social landscape of contraception and abortion care. We describe limitations of the existing evidence supporting use of the LNG-IUD as emergency contraception and highlight the critical research needed to establish the device as a highly effective method of emergency contraception.

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Section: How Does Emergency Contraception Work?mentioning

confidence: 93%

mentioning

confidence: 99%

The Levonorgestrel-Releasing Intrauterine Device as Emergency Contraception

Ramanadhan,

Jensen

2023

Obstetrics &Amp; Gynecology

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show abstract

“…Those with a body mass index (BMI) of more than 30 kg/m 2 have an 8-fold increase in pregnancy rate as compared with those with a BMI of less than 25 kg/m 2 , though the absolute pregnancy rate is low, 12 and experts do not recommend strictly withholding oral LNG EC from overweight and obese patients. 13 No serious side effects from LNG EC have been reported. If vomiting occurs within 3 hours of taking LNG EC, the dose should be repeated.…”

Section: Available Methodsmentioning

confidence: 99%

“…16 UPA is most effective for those with a BMI of less than 35 kg/m 2 and is a better choice than LNG EC for individuals with a BMI between 30 and 35 kg/m 2 . 13 For those with a BMI of more than 35 kg/m 2 , the failure rate of UPA is high. If progestin-only or combined estrogen/progestin contraception is given within 5 days of UPA, the ability of UPA to delay ovulation is impaired.…”

Section: Available Methodsmentioning

confidence: 99%

“…Oral LNG EC is less effective in obese patients or those with a history of bariatric surgery causing malabsorption. Those with a body mass index (BMI) of more than 30 kg/m 2 have an 8-fold increase in pregnancy rate as compared with those with a BMI of less than 25 kg/m 2 , though the absolute pregnancy rate is low,12 and experts do not recommend strictly withholding oral LNG EC from overweight and obese patients 13. No serious side effects from LNG EC have been reported.…”

Section: Available Methodsmentioning

confidence: 99%

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