Emergency hormonal contraception
Emergency or urgent hormonal contraception uncluding https://pillintrip.com/medicine/desirett is used after unprotected sexual intercourse (accidental unprotected intercourse, skipping the pill, expulsion of the coil, rupture of the condom, rape, etc.). Emergency contraception (EC) is considered acceptable if it can be used within a few days of unprotected sexual intercourse.
The mechanism of action of EC consists in desynchronization of menstrual function, which manifests itself in delayed ovulation, its suppression, violation of oocyte transport, etc.
It is important to remember that EC is a one-time contraception and cannot replace a planned permanent contraception.
For emergency hormonal contraception, combined oral contraceptives, progestagens, Mifepristone are used.
The Juzpe method (combined contraceptives) consists of taking 100 mcg of ethinylestradiol and 0.5 mg of levonorgestrel twice. The first dose must be taken within 72 hours of unprotected intercourse, the second 12 hours later. Can be used any combined pill, but necessarily on the dosage correspond to the above-stated – 8 tablets of low-dose OC (30-35 mcg ethinylestradiol), taken in 2 receptions (on 4 tablets) or 4 tablets of high-dose OC (50 mcg ethinylestradiol), taken in 2 receptions on 2 tablets with an interval in 12 hours.
Levonorgestrel (Postinor, Escapel). WHO studies show that the use of levonorgestrel is more effective and has fewer side effects than the Juzpe method. Thus, pregnancy after unprotected intercourse occurred in 3.2% of women who used the Juzpe regimen and 1.1% of those who used levonorgestrel.
The first Postinor pill should be taken within 48 hours of unprotected intercourse, the second 12 hours later. Escapel is used: 1 tablet no later than 72 hours after sexual intercourse.
Mifepristone is used for emergency contraception relatively recently. There is evidence that its use is effective to protect against unplanned pregnancy in the case of a longer interval after unprotected intercourse – up to 120 hours. The current recommendation is to use the drug once in a small dose of 10 mg for 72 hours after unprotected intercourse.
The main side effects of emergency hormonal contraception are menstrual irregularities in subsequent cycles (shortening, lengthening of the cycle, intermenstrual bleeding).
Thus, the development of the contraception problem, the creation of various contraceptives including new highly selective progestagens, the development of prolonged releasing systems for parenteral use, the improvement of emergency contraception methods have significantly expanded the possibilities for clinicians to choose a rational and safe way to prevent unwanted pregnancy for a particular patient.