Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Emergency Contraception and Safety

A look at EC pills and their safety

Publish date:: November 17, 2015

Serious adverse events were rare among women taking levonorgestrel (LNG), ulipristal acetate (UPA), or Yuzpe combined oral contraceptives, in a study of women using these emergency contraceptive pills. When compared with women not taking emergency contraception pills, researchers found:

• Poor pregnancy outcomes were rare among pregnant women repeatedly using LNG ECPs.

• Poor pregnancy outcomes were rare among pregnant women who used LNG or Yuzpe ECPs during the conception cycle or early pregnancy.

• Breastfeeding outcomes did not differ between women exposed to LNG ECP and those unexposed, and there was no increased risk of ectopic pregnancy vs intrauterine pregnancy after repeated use of LNG ECPs vs non-use.

Citation: Jatlaou TC, Riley H, Curtis KM. Safety data for levonorgestrel, ulipristal acetate and Yuzpe regimens for emergency contraception. [Published online ahead of print November 3, 2015]. Contraception. doi: 10.1016/j.contraception.2015.11.001.

Commentary: About 50% of all pregnancies in the United States are unintended. Emergency contraceptive pills can be highly effective in preventing these pregnancies. The levonorgestrel-only method is available over-the-counter without a prescription (Plan B One-Step and many others) while ulipristal acetate (Ella) and combined oral contraceptives (Yuzpe method) require prescriptions. All are most effective when taken directly after unprotected or inadequately protected sex and up to 120 hours after intercourse. Furthermore, multiple studies have concluded that increased access to oral emergency contraceptives doesn’t increase rates of sexually transmitted diseases or unintended pregnancies.¹ Emergency contraception methods are easy to use and, as this article shows, they are safe. Since emergency contraceptive pill efficacy decreases with time since intercourse, adding a brief discussion about emergency contraception at our adolescent and well woman visits allows women to act on this knowledge quickly if the need should arise. – Amy Clouse, MD

1. Raymond EG, Cleland K. Emergency contraception. N Engl J Med 2015;372:1342-1348. doi:10.1056/NEJMcp1406328.

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