{"id":751,"date":"2020-02-17T21:43:45","date_gmt":"2020-02-17T16:13:45","guid":{"rendered":"https:\/\/medicineplexus.com\/?p=751"},"modified":"2020-02-17T21:43:45","modified_gmt":"2020-02-17T16:13:45","slug":"emergency-postcoital-contraceptive-pill","status":"publish","type":"post","link":"https:\/\/medicineplexus.com\/emergency-postcoital-contraceptive-pill\/","title":{"rendered":"Emergency (postcoital) Contraceptive pill"},"content":{"rendered":"\n<p><strong>Emergency (postcoital) pill<\/strong><\/p>\n\n\n\n<ul><li>These are for use in a woman not taking any contraceptive who had a sexual intercourse risking unwanted pregnancy.<\/li><li>reserved for unexpected or accidental exposure (rape, condom rupture) only, because all emergency regimens have higher failure rate and side effects than regular low-dose combined pill.<\/li><li>There are no medical contraindications to use of oral emergency contraception.<\/li><li>Neither a physical examination nor laboratory testing is needed before prescribing levonorgestrel or an estrogen-progestin regimen for emergency contraception<\/li><li>Pregnancy should be excluded and, if not conclusively excluded by history, pregnancy testing should be performed, particularly before prescribing ulipristal or intrauterine contraception.<\/li><\/ul>\n\n\n\n<p>The most commonly used and standard regimen is-<\/p>\n\n\n\n<ol type=\"1\"><li>Levonorgestrel 0.75 mg two doses 12 hours apart, or 1.5 mg single dose taken as soon as possible, but before 72 hours of unprotected intercourse.<\/li><li>Trials conducted globally by a WHO task force on postovulatory methods of fertility control have found this regimen to <strong>be 2-3 times more effective and better tolerated than the earlier &#8216;Yuzpe method<\/strong>&#8216; which used levonorgestrel 0.5 mg + ethinyl estradiol 0.1 mg, two doses at 12 hours interval within 72 hours of exposure.<\/li><li>Incidence of nausea and vomiting is &nbsp;nearly 6% in the progestin only regimen compared to 20-50% with the estrogen + progestin regimen.<\/li><li>Headache and other side effects are also milder.<\/li><li>However, the next period may be delayed or disrupted with either regimens.<\/li><\/ol>\n\n\n\n<ul><li><strong>Ulipristal<\/strong><ul><li>selective progesterone receptor modulator with primarily antiprogestin activity.<\/li><\/ul><ul><li>30 mg single dose as soon as possible, but within 120 hours of intercourse.<\/li><\/ul><ul><li>equally effective (failure rate 1- 3% compared to levonorgestrel 2- 4%) and<\/li><\/ul><ul><li>equally well tolerated alternative method now available with an extended window of protective action&nbsp;<\/li><\/ul><ul><li>Their primary mechanism of action is delay of ovulation, but endometrial effects that may affect implantation may also contribute to efficacy<\/li><\/ul><ul><li>disadvantage of antiprogestins is that the delay in ovulation results in a delay in subsequent menses, which may provoke anxiety about possible pregnancy<\/li><\/ul><\/li><\/ul>\n\n\n\n<ul><li>Another anti-progestin \u00e0 used particularly in Europe and China \u00e0 <strong>Mifepristone 600 mg single dose<\/strong> taken within 72 hours of intercourse.<\/li><\/ul>\n\n\n\n<ul><li>Copper intrauterine contraception inhibits fertilization by affecting sperm viability and function. The copper device also has postfertilization contraceptive effects<ul><li>Copper intrauterine contraception (IUD) is the most effective method of emergency contraception<\/li><\/ul><ul><li>Advantages of this method are that it provides continuing contraception after initial IUD placement, is more effective than oral regimens, especially in overweight\/obese women, and is well tolerated, with one-year continuation rates of 60 percent<\/li><\/ul><\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"682\" height=\"247\" src=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-314.png?w=682\" alt=\"\" class=\"wp-image-795\" srcset=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-314.png 682w, https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-314-300x109.png 300w\" sizes=\"(max-width: 682px) 100vw, 682px\" \/><\/figure>\n\n\n\n<p><strong>Repeated emergency contraception<\/strong> \u2014<\/p>\n\n\n\n<p>There is no contraindication to giving a second dose of hormonal emergency contraception if a second episode of unprotected intercourse occurs any time after the first dose was administered<\/p>\n\n\n\n<p><strong>Investigational drugs:<\/strong><\/p>\n\n\n\n<ol type=\"1\"><li><strong>Prostaglandin inhibitors<\/strong> \u2014 Drugs of this class (COX-1 and COX-2 inhibitors) appear to interfere with several essential steps in female reproduction, including oocyte maturation and ovulation.<ol><li><strong>Meloxicam<\/strong> \u2014 In a study of 41 women with leading follicles \u226515 mm, treatment with meloxicam (15 mg) plus levonorgestrel (1.5 mg) resulted in a significantly higher proportion of cycles with no follicular rupture within five days than treatment with placebo plus levonorgestrel (88 versus 66 percent of cycles)<\/li><\/ol><\/li><\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Emergency (postcoital) pill These are for use in a woman not taking any contraceptive who had a sexual intercourse risking unwanted pregnancy. reserved for unexpected or accidental exposure (rape, condom rupture) only, because all emergency regimens have higher failure rate and side effects than regular low-dose combined pill. There are no medical contraindications to use[&#8230;]\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","footnotes":""},"categories":[3],"tags":[],"_links":{"self":[{"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/posts\/751"}],"collection":[{"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/comments?post=751"}],"version-history":[{"count":0,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/posts\/751\/revisions"}],"wp:attachment":[{"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/media?parent=751"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/categories?post=751"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/tags?post=751"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}