Emergency contraception

Emergency contraception is a method of contraception after unprotected sexual intercourse, when immediate protection against unwanted pregnancy is needed: after accidental sexual intercourse, if a condom breaks, rape, etc.

In these and similar cases, emergency contraception can be considered a real alternative to abortion. However, it cannot be considered a regular method of preventing unplanned pregnancy. Other names for emergency contraception are postcoital or emergency contraception.

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Mechanism of action of emergency contraception

The mechanism of action of emergency contraception is to suppress or delay ovulation, disrupt the process of fertilization, transport of the egg and implantation of the blastocyst. As is known, implantation of the latter into the uterine mucosa begins approximately 5 days after fertilization and ends a week after it. The effect is possible when using emergency contraception during the first 24-72 hours after unprotected sexual intercourse.

Currently, the following are used for emergency contraception:

• COOK;
• progestogens;
• IUDs (copper-containing).

Yuzpe Method

The Yuzpe method, which was developed in 1977 by Yuzpe and Lancy, is a method of emergency contraception using COCs and consists of twice-daily administration of 100 mcg EE and 0.5 mg levonorgestrel.

Reception mode

The first dose should be taken within 72 hours after unprotected intercourse, the second - 12 hours later. For emergency contraception, almost all modern COCs can be used in appropriate doses: 8 tablets of a low-dose COC (containing 30-35 mcg EE), taken in 2 doses with a 12-hour interval, or 4 tablets of a high-dose COC (containing 50 mcg EE), also taken in 2 doses with a 12-hour interval.

Contraindications for use include pregnancy, as well as conditions in which estrogens are contraindicated (history of thromboembolism, severe liver disease, bleeding of unknown etiology, breast and endometrial cancer).

Main side effects: nausea (51%), vomiting (19%), mastalgia, bleeding.

Emergency contraception with progestogens

The drug Postinor, which contains 0.75 mg of levonorgestrel in 1 tablet, and Escapelle, which contains 1.5 mg of levonorgestrel in 1 tablet, are used as progestogen emergency contraception.

Reception mode

Two Postinor tablets are used: the first tablet must be taken within 48 hours after unprotected sexual intercourse, the second - after 12 hours. Escapelle is taken 1 tablet no later than 72 hours after unprotected sexual intercourse.

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Emergency contraception with copper-bearing IUDs

For this purpose, the IUD is inserted into the uterus within 5 days after unprotected intercourse. This method is not indicated for women who have not given birth, as well as for patients with a high risk of developing inflammatory diseases of the genital organs, primarily with sexually transmitted infections, the increased risk of which occurs with a large number of sexual partners and casual sex. The effectiveness of this method is 1 pregnancy per 5,000 cases of use.

Despite the high contraceptive activity of emergency contraception, this method cannot be used constantly - it can only be used in emergency cases.

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