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Table 3 Types of Emergency Contraception

From: Unintended pregnancy: a framework for prevention and options for midlife women in the US

Intrauterine Device (IUD)

IUD

Initiation of EC

Evidence Summary

Cu-IUD (intrauterine copper contraceptive)

• Can be inserted within 5 days of 1st act of unprotected sexual intercourse as an EC.

• Additionally, when can estimate the day of ovulation, can be inserted beyond 5 days after sexual intercourse (as long as insertion does not occur >5 days after ovulation).

• Highly effective.

• Can be continued as regular contraception (Cleland et al., 2012).

Emergency Contraceptive Pills (ECPs)

ECPs

Initiation of EC

Evidence Summary

Ulipristal acetate (UPA)

• Single dose (30 mg)

• Take as soon as possible within 5 days of unprotected sexual intercourse.

• Similar effectiveness to Cu-IUD when taken within 3 days after unprotected sexual intercourse.

• Shown to be more effective than LNG formulation 3–5 days after unprotected sexual intercourse (Glasier et al., 2010).

Levonorgestrel (LNG)

• Single dose (1.5 mg) or

• Split dose (1 dose of 0.75 mg of levonorgestrel, followed by a 2nd dose of 0.75 mg of levonorgestrel 12 h later

• Take as soon as possible within 5 days of unprotected sexual intercourse.

• Similar effectiveness to Cu-IUD when taken within 3 days after unprotected sexual intercourse (Glasier et al., 2010).

• LNG may be less effective than UPA in obese women (Jatlaoui, 2016).

Combined estrogen and progestin in 2 doses (Yuzpe regimen)

• 1 dose of 100 μg of ethinyl estradiol plus 0.50 mg of levonorgestrel followed, by a 2nd dose of 100 μg of ethinyl estradiol plus0.50 mg of levonorgestrel 12 h later

• Take as soon as possible within 5 days of unprotected sexual intercourse.

• Less effective than UPA or LNG.

• Associated with more frequent occurrence of side effects (nausea and vomiting) (Raymond et al., 2004).

  1. Adapted from Curtis et al. (2016). U.S. Selected Practice Recommendations for Contraceptive Use, 2016. MMWR Recomm Rep 2016;65(No. RR-4): [1–66]