Emergency contraception - an evidence-based practice guide

Abstract

Emergency contraception (EC) has the potential to reduce unintended pregnancy and abortion rates. This review provides an overview of the three main methods of EC available in Australia, including the copper intrauterine device and oral ECs, levonorgestrel and ulipristal acetate, and brings together evidence from several guidelines to assist pharmacists’ practices. The relative efficacy and safety of each method are discussed, together with practical recommendations regarding special considerations, including ongoing contraception, women with an elevated body mass index, drug interactions and breastfeeding. An evidence-based treatment algorithm is provided to assist in decision-making regarding EC use, with ulipristal acetate now likely to be the first-line oral EC given its superior efficacy relative to levonorgestrel, irrespective of time taken following unprotected sexual intercourse, but there are special considerations regarding its use. Pharmacists must be aware of key differences in available methods of EC and be prepared to counsel women on such to facilitate shared decision-making.