- EC may be used into the following circumstances: unprotected sexual intercourse, issues about feasible contraceptive failure, wrong usage of contraceptives, and intimate attack if without contraception coverage.
- Ways of crisis contraception would be the copper-bearing intrauterine devices (IUDs) and also the emergency contraceptive pills (ECPs).
- A copper-bearing IUD could be the many form that is effective of contraception available.
- The crisis contraceptive supplement regimens suggested by who will be ulipristal acetate, levonorgestrel, or combined dental contraceptives (COCs) composed of ethinyl estradiol plus levonorgestrel.
What exactly is crisis contraception?
Emergency contraception relates to types of contraception you can use to stop maternity after sexual activity. They are suitable for used in 5 times but are more beneficial the earlier they’ve been utilized following the work of sexual intercourse.
Mode of action
Emergency contraceptive pills prevent maternity by preventing or delaying ovulation and they just do not cause an abortion. The copper-bearing IUD stops fertilization by causing a chemical improvement in egg and sperm before they meet. Crisis contraception cannot interrupt a proven pregnancy or damage an embryo that is developing.
Who is able to utilize crisis contraception?
Any girl or woman of reproductive age might need crisis how to get a brazilian woman contraception to prevent a undesirable maternity. There are not any absolute medical contraindications to the application of crisis contraception. You will find no age limits for the application of crisis contraception. Eligibility criteria for basic usage of a copper IUD also submit an application for utilization of a copper IUD for crisis purposes.
With what situations can emergency contraception be properly used?
Crisis contraception can be utilized in many different circumstances after intercourse. Included in these are:
- Whenever no contraceptive has been utilized.
- Intimate attack if the girl had not been protected by a fruitful contraceptive technique.
- If you find concern of feasible contraceptive failure, from wrong or wrong usage, such as for example:
- Condom breakage, slippage, or use that is incorrect
- 3 or maybe more consecutively missed combined dental contraceptive pills;
- A lot more than 3 hours later through the usual period of intake associated with progestogen-only product (minipill), or maybe more than 27 hours following the pill that is previous
- A lot more than 12 hours late through the usual time of consumption regarding the desogestrel-containing product (0.75 mg) or even more than 36 hours following the past product;
- Significantly more than two weeks later for the norethisterone enanthate (NET-EN) progestogen-only injection;
- Significantly more than 4 weeks belated for the depot-medroxyprogesterone acetate (DMPA) progestogen-only injection;
- Significantly more than seven days later for the combined injectable contraceptive (CIC);
- Dislodgment, breakage, tearing, or very early elimination of a diaphragm or cap that is cervical
- Unsuccessful withdrawal ( e.g. Ejaculation when you look at the vagina or on outside genitalia);
- Failure of a spermicide film or tablet to melt before sex;
- Miscalculation of this abstinence period, or failure to abstain or make use of a barrier technique regarding the fertile times of the period whenever fertility that is using based techniques; or
- Expulsion of a intrauterine contraceptive device (IUD) or hormonal implant that is contraceptive.
An advance way to obtain ECPs can be provided to a female to make certain them available when needed and can take as soon as possible after unprotected intercourse that she will have.
Moving to regular contraception
After usage of ECPs, females or girls may resume or initiate a regular way of contraception. No additional contraceptive protection is needed if a copper IUD is used for emergency contraception.
After management of ECPs with levonorgestrel (LNG) or combined dental contraceptive pills (COCs), females or girls may resume their contraceptive technique, or begin any method that is contraceptive, including a copper-bearing IUD.
After utilization of ECPs with ulipristal acetate (UPA), females or girls may resume or begin any progestogen method that is containing combined hormonal contraception or progestogen only contraceptives) from the 6th time after using UPA. They are able to have an LNG-IUD placed immediately if it may be determined they’re not expecting. The copper can be had by them IUD inserted instantly.
Ways of crisis contraception
The 4 types of crisis contraception are:
- ECPs containing UPA
- ECPs containing LNG
- Combined dental pills that are contraceptive
- Copper-bearing intrauterine products.
Crisis contraception pills (ECPs) and combined oral pills that are contraceptiveCOCs)
Whom suggests any of the following medications for emergency contraception:
- ECPs with UPA, taken as a solitary dosage of 30 mg;
- ECPs with LNG taken being a single dosage of 1.5 mg, or alternatively, LNG used 2 doses of 0.75 mg each, 12 hours aside.
- COCs, taken as a split dosage, one dosage of 100 ?g of ethinyl estradiol plus 0.50 mg of LNG, accompanied by a 2nd dose of 100 ?g of ethinyl estradiol plus 0.50 mg of LNG 12 hours later on. (Yuzpe technique)
A meta-analysis of two studies revealed that ladies who utilized ECPs with UPA possessed a maternity price of 1.2per cent. Research indicates that ECPs with LNG possessed a maternity price of 1.2per cent to 2.1per cent (1) (2).
Preferably, ECPs with UPA, ECPs with LNG or COCs should be used as early as feasible after unprotected sex, within 120 hours. ECPs with UPA are far more effective between 72–120 hours after unprotected sex than other ECPs.
Unwanted effects through the utilization of ECPs resemble those of dental contraceptive pills, such as for instance sickness and sickness, slight irregular bleeding that is vaginal and exhaustion. Negative effects aren’t typical, they truly are moderate, and certainly will usually resolve without further medications.
If nausea does occur within 2 hours of going for a dosage, the dosage must certanly be duplicated. ECPs with LNG or with UPA are better than COCs simply because they cause less vomiting and nausea. Routine utilization of anti-emetics before using ECPs just isn’t recommended.
Medications employed for crisis contraception try not to harm fertility that is future. There is absolutely no wait within the come back to fertility after taking ECPs.
Health eligibility requirements
There aren’t any limitations when it comes to eligibility that is medical of may use ECPs.
Some ladies, but, utilize ECPs over and over over repeatedly for almost any of this reasons stated above, or as their primary way of contraception. Such situations, further counselling has to be provided on which other and much more regular contraceptive choices can be appropriate and much more effective.
Regular and repeated ECP use can be harmful for ladies with conditions categorized as medical eligibility criteria (MEC) category 2, 3, or 4 for combined contraception that is hormonal Progestin-only contraceptives (POC). Regular utilization of crisis contraception can lead to increased side-effects, such as for instance menstrual problems, although their repeated use poses no understood health problems.
Emergency contraceptive pills had been discovered to be less effective in overweight ladies (whoever human body mass index is more than 30 kg/m2), but there are not any security issues. Overweight females shouldn’t be rejected usage of crisis contraception whenever they require it.
Counselling for use of crisis contraceptive pills includes choices for making use of contraception that is regular suggestions about just how to utilize techniques precisely in case there is recognized method failure.
Copper-bearing devices that are intrauterine
Whom suggests that the copper-bearing IUD, when utilized as an urgent situation contraceptive technique, be placed within 5 times of unprotected sex. This technique is specially right for ladies who wish to begin using an efficient, long-acting, and reversible contraceptive technique.
Whenever placed within 120 hours of unprotected sex, a copper-bearing IUD is significantly more than 99% effective in preventing maternity. Here is the most effective kind of crisis contraception available. As soon as placed, ladies can continue steadily to make use of the IUD as a continuous approach to contraception, or might want to alter to some other contraceptive technique.
A copper-bearing IUD is really a safe as a type of crisis contraception. It’s estimated that there could be lower than 2 situations of Pelvic Inflammatory Disease (PID) per 1000 users (3). (FP Global Handbook). The potential risks of perforation or expulsion are low.
Medical eligibility requirements
Eligibility requirements for basic utilization of a copper IUD also make an application for usage of a copper IUD for crisis purposes. Women with an ailment categorized as MEC category three or four (for instance, with present PID, puerperal sepsis, unexplained genital bleeding, cervical cancer tumors, or serious thrombocytopenia) when it comes to copper IUD must not make use of copper IUD for crisis purposes. In addition, a copper-bearing IUD shouldn’t be inserted for crisis contraception after intimate attack as the lady may be at high danger of a sexually transmitted illness such as for instance chlamydia and gonorrhoea. A copper-bearing IUD shouldn’t be utilized as crisis contraception whenever a lady is expecting.
The whom health eligibility requirements for contraceptive usage states that IUD insertion may increase the risk further of PID among ladies at increased risk of intimately sent infections (STIs), although limited proof shows that this risk if low. Present algorithms for determining increased threat of STIs have bad value that is predictive.