Emergency Contraception

Abstract

Emergency contraception (EC) methods are back-up methods to be used upon omission or failure of one’s regular contraception. Current options include the copper intrauterine contraceptive device and oral hormonal methods. The copper intrauterine contraceptive device, inserted within 120 h of unprotected sexual intercourse (UPSI), is the most effective option for EC and can be retained as an ongoing contraception. Recommended oral hormonal methods including a single dose of levonorgestrel 1.5 mg taken within 72 h or ulipristal acetate 30 mg taken within 120 h of UPSI, which have lower side effect profile compared to the Yuzpe regimen. Mifepristone 25–50 mg may have higher efficacy, but this formulation is licensed in few countries only. The oral methods mainly act by inhibiting or postponing ovulation, although mifepristone, like the intrauterine device, may also interfere with implantation. All EC methods are not abortifacients. Proper understanding and awareness about EC is an important part of contraceptive education. Various myths and misconceptions about their mechanisms of action and practical usage do exist and need to be dispelled based on the current evidence. Over-the-counter or advanced provision could facilitate timely access to EC when needed and will not promote its abuse nor encourage risky sexual behaviours.