Postcoital contraception: a report from the London Brook Advisory Centres, United Kingdom
Hutchinson, F.
Entre Nous 1985(7): 1-3
1985
ISSN/ISBN: 1014-8485 PMID: 12222329 Document Number: 382818
This information bulletin provides guidelines on postcoital contraception. In the UK, this has become an increasingly acceptable and available method for use where there has been unprotected intercourse or contraception failure. There are currently 2 methods available: the morning-after pill (used in 1026 cases in 1983) and the insertion of an intrauterine device (63 cases in 1983). The morning-after pill regimen under use involves administration of 2 tablets of a combined estrogen-progestogen pill (together containing .1 mg ethinyl estradiol and 1 mg norgestrel), followed by another dose of 2 tablets 12 hours later. This method has fewer side effects than the large estrogen doses used previously. The postcoital contraception failure rate has been estimated at 1.6-3.5%. For maximum success, the following criteria should be met: treatment begun within 72 hours of unprotected intercourse, only 1 incident of unprotected intercourse in the menstrual cycle, agreement of the patient to abstain or use additional contraceptive methods until the next menstrual period, and agreement to return for follow-up to ensure that there is not a continuing pregnancy. Postcoital IUD insertion can be used up to 5 days after exposure, but is not advised in nulliparous women because of the risk of pelvic inflammatory disease. There are several guidelines suggested to medical practitioners. Counselling should include discussion of future contraception. There is also a need to make both the general public and physicians more aware of the availability of this method. It should be stressed that the likelihood of an unwanted pregnancy that might lead to an abortion can be reduced from 30% to 3% with the use of postcoital contraception.