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Emergency Contraception

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MedicineAndHealth14

The document provides an overview of emergency contraception (EC), including its history, methods, efficacy, side effects, and guidelines for use. It discusses the Yuzpe method (combined pill), Plan B (progestin-only pill), high-dose estrogen, and copper IUD. Key points are that EC prevents pregnancy by delaying or inhibiting ovulation and works best the sooner it is taken after unprotected sex. Advance provision of EC has been shown to reduce unintended pregnancies.

Health & Medicine
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Emergency Contraception Bliss Kaneshiro September 17, 2003
Emergency Contraception: Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What is Emergency Contraception (EC) ? ,[object Object],[object Object],[object Object]
Who can use EC? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Am J Prev Med 2000;19:228-229
When do women actually use EC? Obstet Gynec 2003;101:1160-1167
Why is EC needed? ,[object Object],[object Object],[object Object],[object Object],J Am Med Women’s Assoc 1998;53:215-216 Fam Plann Persp 1998;30:24-29
The History of EC ,[object Object],[object Object],[object Object],[object Object]
EC is Not a New Idea…. ,[object Object],[object Object],[object Object],[object Object],[object Object]
Methods ,[object Object],[object Object],[object Object],[object Object]
Combined method of emergency contraception ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Fertil Steril 1997;28:932-936
Combined method: How does it work? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Combined method: Efficacy ,[object Object],[object Object],Fam Plann Perspect 1996;28:58-64
Combined Method: Efficacy ,[object Object],[object Object],[object Object],[object Object],[object Object],Lancet 1999:353;721
Is EC effective after 72 hrs? ,[object Object],[object Object],[object Object],[object Object]
Efficacy after 72 hours ,[object Object]
Combined Method: side effects ,[object Object],[object Object],[object Object],[object Object],ACOG Practice Bulletin 2001;25
Combined Method: Side Effects (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],Obstet Gynecol 2000;95:271 Am J Obstet Gynecol 2003;88:389
Combined Method: side effects (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Fertil Steril 1982;37:508-513
Modifying the Yuzpe Method ,[object Object],[object Object],[object Object]
Modifying the Combined Method (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Obstet Gynecol 2003;101:1160-1167
Modifying the Combined Method (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Obstet Gynecol 2003;101:1160-1167
Progestin Only method: Plan B ,[object Object]
Progestin Only Method: How does it work? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Contraception 2001;64:227-234
Progestin Only Method: How does it work? (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Contraception 2001;64:227-234
Progestin Only Method: How does it work? (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],Contraception 2001;64:227-234
Progestin Only Method: How does it work? (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Contraception 2001;64:227-234
Progestin Only Method: How does it work? (cont’d) ,[object Object],[object Object],[object Object],[object Object],Contraception 2001;64:227-234
Progestin Only Method: How does it work? (cont’d) ,[object Object],[object Object],[object Object],Contraception 2001;64:227-234
Progestin Only Method: Efficacy ,[object Object],[object Object],[object Object],[object Object],[object Object],Lancet 1998;352:428-432
Modifying the Progestin Only Method ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Lancet 2002;360:1803-10
Modifying the Progestin Only Method (Cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],Lancet 2002;260:1803-10
High Dose Estrogen ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Copper IUD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
Contraindications to EC ,[object Object],[object Object],[object Object]
Contraindications (continued) ,[object Object],[object Object],[object Object],[object Object]
Contraindications (continued) ,[object Object],[object Object],[object Object],[object Object],Fertil Control Rev 1995;4:16-18
Contraindications (cont’d) ,[object Object]
Contraindications (cont’d) ,[object Object],[object Object],[object Object],[object Object]
Utilizing EC
Utilizing EC ,[object Object],[object Object],[object Object],[object Object],[object Object]
Do patients know about EC? ,[object Object],[object Object],[object Object],[object Object]
Do health care providers discuss EC with their patients? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Should women be given an advance supply of EC? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],N Engl J Med 1998;229:1-4
Should women be given an advance supply of EC (cont’d)? ,[object Object],[object Object],[object Object],[object Object],Obstetrics and Gynecology 2003;102
Should women be given an advance supply of EC (cont’d)? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Can the public understand how to take EC without seeing an MD? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Obstet Gynecol 2002;100:342-9
Can the public understand how to take EC without seeing an MD? ,[object Object],[object Object],[object Object],[object Object],[object Object],Obstet Gynecol 2003;102:17-23
Can the public understand how to take EC without seeing an MD (cont’d)? ,[object Object],[object Object],[object Object],Obstet Gynecol 2003;102:17-23
ACOG Guidelines ,[object Object]
The Washington Experience
The Washington Experience ,[object Object],[object Object],[object Object],[object Object]
The Washington Experience (continued) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Washington Experience (continued) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],PATH: Executive Summary of Findings
EC in the United States ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What about Hawaii?
What about Hawaii? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hawaii Emergency Contraception Access Survey (2001-2002) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Hawaii Emergency Contraception Access Survey (2001-2002) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hawaii Emergency Contraception Access Survey (2001-2002) ,[object Object],[object Object],[object Object]
Do pharmacies in Hawaii currently stock EC? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Do pharmacies in Hawaii currently stock EC (cont’d)? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Plans for Hawaii ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Plans for Hawaii ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Plans for Hawaii (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Plans for Hawaii (cont’d) ,[object Object],[object Object],[object Object],[object Object]
Conclusion ,[object Object],[object Object],[object Object],[object Object]
Conclusion (cont’d) ,[object Object],[object Object],[object Object]
Thanks to ,[object Object],[object Object],[object Object],[object Object]

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Emergency Contraception