This document discusses different types of emergency contraception and birth control methods including combination birth control pills and progestogen-only pills. It provides information on how each method works, effectiveness rates, benefits and risks, side effects, drug interactions, complications and important considerations for patient education. The methods discussed are levonorgestrel, ulipristal acetate, combination birth control pills containing estrogen and progestin, and progestogen-only pills.

1. Emergency Contraception
Combination Birth Control Pills
Progestogen-only Pills
Genevieve Angayen
Joanna Cua
Jessamine David
Maria Cassandra May Dizon

3. Emergency Contraception
Levonorgestrel
Ulipristal Acetate

5. How does Levonorgestrel work?
Levonorgestrel is in a class of medications called
progestins. It works by preventing the release of an egg from
the ovary or preventing fertilization of the egg by sperm
(male reproductive cells). It also may work by changing the
lining of the uterus (womb) to prevent development of a
pregnancy.
Joanna Cua

6. Effectiveness Rate
If you take it within 72 hours after you've had
unprotected sex, Plan B One-Step can reduce the risk of
pregnancy by up to 89%. If you take Plan B One-Step within
24 hours, it is about 95% effective.
Joanna Cua

7. Benefits and Risks
BENEFITS
● It's available to all women
who needs it.
● It’s available over the
counter.
● It works right away if used
as directed.
RISK
Joanna Cua

8. Side Effects
Some women may experience some side effects including;
● Period that is heavier, lighter, earlier, late
● Nausea
● Abdominal Pain
● Fatigue
● Headache
● Dizziness
● Breast Tenderness
● Vomiting
Joanna Cua

9. Drug Interactions
May change how your medications work or increase your
risk for serious side effects. Some products that may interact
with this drug include: drugs affecting liver enzymes that
remove levonorgestrel from your body (such as bosentan,
modafinil, nevirapine, HIV protease inhibitors including
ritonavir, griseofulvin, rifamycins including rifabutin, St. John's
wort, certain anti-seizure medicines including carbamazepine,
phenytoin, phenobarbital), sodium tetradecyl sulfate,
troleandomycin.
Joanna Cua

10. ● Teach patient that this is not an alternative to regular birth
control because it's not as effective as a regular birth control.
● Tell patient that if they're sexually active to consider having a
regular birth control method.
● This doesn't protect them from having any sexually
transmitted disease.
● Even though it prevent pregnancy, keep in mind that this
doesn't prevent the spread of HIV.
Patient Education
Joanna Cua

11. Ulipristal Acetate
Delays follicular development and ovulation
and inhibits endometrial proliferation.
Jessamine David

12. Jessamine David

13. How to use?
Take a single dose PO within 5 days after intercourse.
How effective is it?
Up to 95% effective. The odds of pregnancy after
taking ella are about half the odds of pregnancy after
taking Plan B One-Step, Levonorgestrel, or Next Choice
pills.
Jessamine David

14. What are the benefits of
Ulipristal Acetate?
● Effective if used within 120 hours compared to
Levonorgestrel, which should be taken within 72 hours.
● Does not impact long-term fertility.
● It treats uterine fibroids.
What are the risks?
● May cause fetal harm if inadvertently administered during
pregnancy.
● Reduces the action of regular hormonal contraceptive
methods.
● Not recommended for nursing mothers.
Jessamine David

15. Side Effects
● Headache
● Nausea
● Abdominal Pain
● Dysmenorrhea
● Fatigue
● Dizziness
Do not take if:
● Suspects pregnancy
● Lower abdominal pain after
taking it
● If patient had past ectopic
pregnancy
Drug Interaction
● Drugs or herbal products that
induce CYP3A4 decrease the
plasma concentrations of
ulipristal acetate, and may
decrease its effectiveness
Jessamine David

16. What to teach patient?
● Do not replace a regular method of
contraception
● If vomiting occurs within 3 hours of
administration, consideration should be given
to repeating dose.
Jessamine David

17. Combination Birth
Control Pills

18. Combination Birth Control Pills:
Methods of Action
● Also known as “The Pill”
● Contains a combination of estrogen and progestin
● Suppress ovulation by keeping ovaries from releasing eggs.
● Inhibit female fertility
Maria Cassandra May Dizon

19. How to use the method
properly
Two types of combination birth control pill
1.Conventional pack - which are packed in 28 day cycle or 21 day cycle.
● For the 21-pill packet, a pill is consumed daily for three weeks, followed by
a week of no pills. For the 28-pill packet, 21 pills are taken, followed by a
week of placebo or sugar pills.
2.Continuous dosing or extended cycle has 84 active pills and 7 inactive pills
and taken every day at the same time.
Maria May Dizon

20. How to use the method properly
Formulations may be:
1. Monophasic. In this type of combination birth control pill, each
active pill contains the same amount of estrogen and progestin.
2. Biphasic. In this type of combination birth control pill, active pills
contain two different combinations of estrogen and progestin.
3. Triphasic. In this formulation, active pills contain three different
combinations of estrogen and progestin. In some types, the
progestin content steadily increases — while in others the progestin
dose remains steady and the estrogen content increases.
Maria May Dizon

21. Maria May Dizon

22. Effectiveness rate:
9 out of 10 women taking combination birth control
pill will get pregnant in the first year of use. With a
perfect use as prescribed, pregnancy rate may be as low
as 1 in 100 women every year
Maria May Dizon

23. Benefits and Risks
BENEFITS:
● Prevents pregnancy
● Eases menstrual cramps
● Shorten and regulates period
● Decrease incidents of ovarian
cyst
● Decreases acne
● Reduces the risk of ovarian and
endometrial cancer.
● Better control of monthly cycle
and a reduction in hot flashes
for women in perimenopause
RISKS:
● Blood clots in the legs
● Worsening of gallbladder disease
● Heart attacks and stroke (smoking
greatly increases the risk of these
complications)
● Depression
● Venous thromboembolism
Maria May Dizon

24. Side Effects/ Drug Interactions
● Nausea
● Headache
● Breast tenderness
● Breakthrough bleeding
● Moodiness
● Weight changes
● Spotting
● Antibiotics
(cephalosporins)
● Anticonvulsants (Tegretol)
● HIV drugs (Viracept)
Maria May Dizon

25. Complications/Contraindications
● Women with pre-existing cardiovascular disease
● Women who have tendency to form blood clots
● Women with severe obesity
● Women who are smoking
Patient Education
● Consult a healthcare provider about the start date
● Pick a time to regularly take the pill
● Follow health care provider’s instruction
● Be cautious with missed pills (read the instructions carefully)
● Do not take a break between each pack
Maria May Dizon

26. Progestin-only Pills

27. Method of Action:
POP can be generally classified into three types of doses:
● Very low dose POP contraceptives
● Intermediate dose progestin-only pills
● High dose progestin-only pills
How to use the method properly
There are two different types of progestogen-only pill:
● The three-hour progestogen-only pill must be taken within three hours of
the same time each day.
● The 12-hour progestogen-only pill must be taken within 12 hours of the
same time each day.
Genevieve Angayen

28. Effectiveness rate:
POPs are very much effective in preventing unwanted pregnancy up
to 99% if taken as directed.
Genevieve Angayen

29. Benefits:
● It does not interrupt sex
● You can use it when breastfeeding
● It is useful if you cannot take the hormone estrogen, which is in the
combined pill, contraceptive patch and vaginal ring
● You can use it at any age – even if you smoke and are over 35
● It can reduce the symptoms of premenstrual syndrome (PMS) and painful
periods
● Pregnancy does not affect the baby
Risks:
● The progestogen-only pill is very safe to take. However, as with the
combined contraceptive pill, there are certain risks. These risks are
small. For most women, benefits of the progestogen-only pill outweigh
the risks.
● Ovarian cysts
● Breast cancer
Genevieve Angayen

30. Effects/ Drug Interactions
enderness and breast enlargement
ased or decreased sex drive
hanges
he and migraine
or vomiting
mall fluid-filled sacs) on your ovaries (these are usually harmless and
ar without treatment)
h upset
gain
be able to use it if you have had:
eaase
ease
ncer
your ovaries
Genevieve Angayen

31. Complications/Contraindications
● Antibiotics
● Epilepsy and HIV medicines, and St John’s wort
Examples of enzyme inducers are:
● the epilepsy drugs carbamazepine, oxcarbazepine, phenytoin,
phenobarbital, primidone and topiramate
● St John’s wort (a herbal remedy)
● some antiretroviral medicines used to treat HIV (research suggests
interactions between these medicines and the progestogen-only pill can
affect the safety and effectiveness of both)
Genevieve Angayen

32. Patient Education:
● Choose a convenient time in the day to take your first pill.
● Continue to take a pill at the same time each day until the pack is
finished.
● Start your next pack of pills the following day. There is no break
between packs of pills.
● Get medical advice if you have a sudden or unusual pain in your
abdomen (tummy), or if your period is much shorter or lighter than
usual. It is possible that these are warning signs of an ectopic
pregnancy, although this is rare.
Genevieve Angayen