Clinical follow-up is not necessary after the administration of emergency contraception. The woman should be advised that if her menstrual period is delayed by a week or more, she should consider the possibility that she may be pregnant, and see her practitioner. Evaluation is also necessary should the woman experience signs of a spontaneous abortion or ectopic pregnancy. In addition, women should be offered sexually transmitted disease screening in a follow-up appointment or at the time of administration of the emergency contraception.
The Bottom Line
Emergency contraception is underused, and the most important barrier to use is a lack of information. The levonorgestrel-only regimen is more effective than the combined regimen, with less nausea associated with it and is therefore the preferred regimen. Emergency contraception can be made available for up to 5 days after intercourse.
It is recommended that when initiating family planning or contraception discussions, emergency contraception options should be discussed and prescribed.
A list of commonly prescribed oral contraceptives that can be used for emergency contraception in the United States can be found at the following two excellent Web sites: http://ec.princeton.edu/ and http://ec.princeton.edu/questions/dose.html#dose.
References
• Emergency Contraception. ACOG Practice Bulletin 112, May 2010.
Dr. Ward is a first-year ob.gyn. resident at Abington (Pa.) Memorial Hospital. Dr. Skolnik is an associate director of the family medicine residency program at Abington Memorial Hospital.