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Facts about Emergency Contraception

Contraception and family planning  •  9 December 2022  • 4 min read



Emergency Contraception Pills (ECP) are hormonal methods of contraception that can reduce the risk of pregnancy following an unprotected act of sexual intercourse.

There are different types of ECPs. Examples include levonorgestrel 1.5mg tablet (An example is BK-1 Emergency Contraception Pills),Ulipristal Acetate tablets, Mifepristone tablets. Some types of ECP such as ulipristal acetate (UPA) or mifepristone are more effective than LNG-only ECPs.

Effectiveness may be affected by the use of certain medications. Such as rifampicin used in the management of infections such as tuberculosis, griseofulvin which is an antifungal, Saint John’s Wort used as an antidepressant, certain anticonvulsant drugs and certain antiretroviral drugs (ritonavir).

Evidence suggests that LNG ECPs may be less effective in women with higher weight and/or BMI. UPA ECPs seems to be more effective in these women than LNG ECPs.

Research studies have shown that Levonorgestrel (LNG) ECPs prevent or delay ovulation. If they are taken before ovulation, LNG ECPs inhibit the pre-ovulatory luteinizing hormone (LH) surge, which impedes follicular development and/or the release of the egg itself.

ECPs do not inhibit implantation of a fertilized egg and therefore ECPs do not cause abortion of an existing pregnancy. If ECPs are taken after a pregnancy is established, they will not work.

If 100 women each had sex once during the 2nd or 3rd week of the menstrual cycle without using contraception, 8 would likely become pregnant.

If all 100 women used progestin (LNG)-only ECPs, one would likely become pregnant.

Effectiveness depends on where a woman is in her menstrual cycle, when she had unprotected sex and when she used ECPs.

ECPs have no known serious complications.  They are safe for use by all women including adolescents. ECPs are not harmful if taken by a woman who is already pregnant.

LNG and UPA ECPs are well tolerated and leave the body within a few days. Some women experience mild and short-term side effects. These may include:

Slight irregular bleeding for 1–2 days after taking ECPs, monthly bleeding that starts earlier or later than expected. Other side effects include Nausea, Abdominal pain, Fatigue, Headaches, Breast tenderness, Dizziness, Vomiting.

ECPs have been widely used in various formulations for over 30 years. According to the World Health Organization (WHO) there are no contraindications for ECPs because the amount of hormone is too small to have a clinically significant impact and the duration of use is very short. In addition, these ECPs do not contain estrogen, which is associated with some contraindications, particularly over long-term use. The WHO states that ECPs have no clinically significant impact on conditions such as cardiovascular disease, angina, acute focal migraine, or severe liver disease.

There are no health conditions that would prevent you from giving ECPs. No pregnancy test or physical examination is needed before giving ECPs. ECPs should not be taken if a woman is pregnant because they will not work.

LNG ECPs are effective when they are taken up to 5 days (120 hours) after sex. But the sooner it is taken after sex the more effective it is in preventing pregnancy.

LNG tablets for emergency contraception are presented as 1 tablet of 1.5 mg

Levonorgestrel, (for example BK-1 Emergency Contraception Pill) or 2 tablets of 0.75 mg levonorgestrel labelled to be taken 12 hours apart.

Levonorgestrel, (for example BK-1 Emergency Contraception Pill) or 2 tablets of 0.75 mg levonorgestrel labelled to be taken 12 hours apart.

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