27th June 2023

Emergency Contraception

These methods are used when a person has had unprotected sexual intercourse (UPSI), including failure of contraceptive, for example ‘missed pill’, and does not wish to conceive. They should be considered if UPSI has occurred on any day of a natural menstrual cycle, if a hormonal method has been used incorrectly, from 21 days postpartum unless lactational amenorrhea criteria have been met, or 5 days from a miscarriage, abortion, or ectopic pregnancy.

Options include oral levonorgestrel, oral ulipristal acetate and the copper IUD. Both oral methods work by delaying or preventing ovulation, so are less effective if taken late in the cycle after ovulation has occurred. The copper IUD relies on its toxic effects on ova and sperm, so it is effective at any point in the cycle. Emergency contraception should be given as close to the UPSI as possible, with the more effective method being the copper IUD – this can be placed up to 5 days from UPSI. Ulipristal acetate is licensed for 5 days following UPSI, and levonorgestrel for 72 hours.