NEET PG High-Yield: Emergency Contraception (EC)
Post-coital contraception, or Emergency Contraception (EC), is intended for use after unprotected sexual intercourse to prevent an unintended pregnancy. It is not a regular method of contraception.
Primary Methods & Efficacy
| Method | Time Window | Mechanism |
|---|---|---|
| Cu-T 380A (IUD) | Within 5 days (120 hrs) | Inhibits fertilization/implantation. |
| Levonorgestrel (Pill) | Ideally < 72 hours | Delays or inhibits ovulation. |
| Ulipristal Acetate | Up to 5 days (120 hrs) | Selective Progesterone Receptor Modulator. |
Key Clinical Points
- Most Effective: The Copper-T IUD is the most effective form of EC, regardless of BMI or time since intercourse (within the 5-day limit).
- Levonorgestrel Dosage: A single dose of 1.5 mg is standard. It is less effective in women with high BMI (> 30 kg/m²).
- Ulipristal Acetate: More effective than Levonorgestrel, especially between 72–120 hours.
- Yuzpe Regimen: Older method using combined OCPs (high-dose estrogen/progestin). Higher incidence of nausea/vomiting; generally not preferred now.
High-Yield NEET PG Pearls:
- Mechanism: EC works primarily by delaying or inhibiting ovulation. It does not disrupt an established pregnancy (it is not an abortifacient).
- Efficacy: Efficacy decreases as the time since unprotected intercourse increases.
- Follow-up: If menses is delayed by > 1 week after taking EC, a pregnancy test is mandatory to rule out treatment failure.
- Barrier Protection: EC does not provide protection against STIs.