Emergency contraceptives: A review of available options

Abstract

Emergency contraception is a method of contraception administered after unprotected vaginal intercourse to prevent an unplanned pregnancy. Although, emergency contraceptives (EC) have been around for at least two decades, surveys have shown there are gaps in both health professionals and women’s knowledge. Today, there are four main types of EC available: the non-hormonal copper intrauterine device, combined oral estrogen and progestin (Yuzpe regimen), oral progestin-only (levonorgestrel), and oral antiprogestin (ulipristal acetate or mifepristone). This article compares the efficacy, mechanism of action, availability and cost of these methods to help guide health professionals and patients when determining an appropriate EC. Pertinent literature was reviewed, including primary research and guidelines, to provide a current review of options. The copper intrauterine device provides the most effective form of EC and can continually be used as a regular contraceptive. Levonorgestrel (Plan B®) is widely available without a prescription and can be used up to three days after unprotected vaginal intercourse. The Yuzpe regimen is inexpensive, though it is often associated with side effects. Ulipristal acetate and mifepristone are both effective up to five days after unprotected vaginal intercourse; however, mifepristone is currently unavailable in Canada.