Makindo Medical Notes

⚠️ Emergency Contraception (EC) helps prevent pregnancy after unprotected sexual intercourse or contraceptive failure. ❌ It does not protect against sexually transmitted infections (STIs).

👩‍⚕️ Who Might Need EC?

• Unprotected sex (no condom used, condom broke/slipped).
• Missed hormonal contraception (e.g., pills, patches, injection late).
• Sexual assault where pregnancy is a risk.

💊 Types of Emergency Contraception

1. Levonorgestrel (LNG) Pills: 🌟 Best taken within 72 hours (3 days), though some benefit up to 120 hrs (5 days). 💡 Less effective in higher BMI (>26).
2. Ulipristal Acetate (UPA, Ella): 📆 Effective up to 120 hours (5 days). ⚖️ More effective than LNG late in the window. ❗ Delay restarting hormonal contraception for 5 days after UPA.
3. ⚙️ Copper Intrauterine Device (IUD): Most effective form of EC, inserted within 5 days. ✨ Provides ongoing long-term contraception once in place. Useful if patient wants both EC + reliable contraception.

🔬 How EC Works

• 💊 LNG & UPA: Delay or inhibit ovulation. Less effective if ovulation has already occurred.
• ⚙️ Copper IUD: Creates a toxic environment for sperm and ova → prevents fertilisation ± implantation.

⏱️ Timing & Effectiveness

⏳ The sooner, the better! - LNG: best within 72 hrs. - UPA: works up to 120 hrs. - Copper IUD: ≤5 days, and may be considered later depending on cycle/ovulation timing.

🤕 Possible Side Effects

• 🤢 Nausea, vomiting.
• 🔴 Irregular bleeding/spotting.
• 🤕 Headache, dizziness.
• 🤱 Breast tenderness.

❗ If vomiting occurs within 2 hrs (LNG) or 3 hrs (UPA), repeat the dose or seek medical advice.

📌 Follow-Up & Next Steps

• 🩸 If period delayed >1 week → take a pregnancy test.
• 👩‍⚕️ Arrange ongoing contraception (pill, implant, IUD, injection).
• 🧪 Consider STI testing if exposure risk.
• 🚨 Seek urgent help if severe abdominal pain (possible ectopic pregnancy).