ECPs

1. Emergency contraception pills
FAMILY PLANING
BSC MW 3
ELISHA JR
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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.
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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.
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4. In what situations should emergency
contraception be used?
A. When no contraceptive has been used.
B. In cases of sexual assault when the woman was not
protected by an effective contraceptive method.
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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;
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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.
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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
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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.
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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.
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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
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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.
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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
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13. • There is no evidence that hormonal emergency
contraception dislodges the embryo after implantation has
occurred. Hormonal emergency contraception does not
cause an abortion
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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.
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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.
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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.
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17. Efficacy
• The efficacy is better the sooner the method is used after
sex.
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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
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19. Less common side effects include;
• Nausea
• Headaches
• Breast tenderness
• Dizziness
• Vomiting
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20. Who is this method good for?
• Safe for all women—even women who cannot use ongoing
hormonal contraceptive methods
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21. References
1. Family Planning a global handbook for provider by J Hopkins
2. www.who.int/mediacentre/factsheets/fs244/en/ [retrieved on
6/12/2015 at 9AM]
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