A copper IUD is the most effective postcoital contraception method. It can be inserted within 5-6 days after the intercourse.
The effect of hormonal postcoital contraceptive pills is best if taken within 12 hours after unprotected intercourse. Depending on the country, they may be available in the pharmacy as over-the-counter products without age limit.
Levonorgestrel 1.5 mg is taken as soon as possible, at the latest 72 hours after intercouse. If taken later, the effect is more unreliable.
Pregnancy starts in 1-2.5%.
Contraindications
No other contraindications than pregnancy
Adverse effects
Mild nausea
Ulipristal acetate
Ulipristal acetate (Ellaone® , 1 tablet) is a synthetic progesterone receptor modulator.
Indicated for emergency contraception within 120 hours (5 days) of unprotected sexual intercourse or contraceptive failure.
Contraceptive effectiveness is similar to levonorgestrelInterventions for Emergency Contraception when emergency contraception is used 0-72 hours after sexual intercourse. In a trial where emergency contraception was taken 48-120 after intercourse, pregnancy rate was 2.1%, i.e. 61% of the expected pregnancies were prevented.
Contraindications
No other contraindications than pregnancy
Adverse effects
Gastrointestinal adverse effects are the commonest.
Postcoital contraception during breastfeeding
Lactation is not a contraindication; however, the infant can be protected from the exogenous steroids by skipping one breastfeeding session after levonorgestrel and replacing it with manual or mechanical emptying of the breasts. Lactation is not recomended for one week after ulipristal acetate.
If there is a suspicion of cervicitis, an IUD may be inserted at discretion, but the samples to detect infections (gonococcal and chlamydial) must be taken in advance, and a course of antimicrobials is prescribed without waiting for the results.