Emergency contraception. Widely available and effective but disappointing as a public health intervention: a review

Hum Reprod. 2015 Apr;30(4):751-60. doi: 10.1093/humrep/dev019. Epub 2015 Feb 11.

Abstract

Emergency contraception (EC) prevents pregnancy after unprotected sex or contraceptive failure. Use of EC has increased markedly in countries where a product is available over the counter, yet barriers to availability and use remain. Although effective in clinical trials, it has not yet been possible to show a public health benefit of EC in terms of reduction of unintended pregnancy rates. Selective progesterone receptor modulators developed as emergency contraceptives offer better effectiveness than levonorgestrel, but still EC is less effective than use of ongoing regular contraception. Methods which inhibit ovulation whenever they are taken or which act after ovulation to prevent implantation and strategies to increase the uptake of effective ongoing contraception after EC use would prevent more pregnancies.

Keywords: contraception; effectiveness; emergency; future; review.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Coitus
  • Contraception
  • Contraception, Postcoital / statistics & numerical data*
  • Contraceptive Agents / therapeutic use
  • Contraceptives, Postcoital / therapeutic use*
  • Female
  • Fertility
  • Humans
  • Levonorgestrel / therapeutic use*
  • Middle Aged
  • Ovulation
  • Pregnancy
  • Pregnancy Rate
  • Pregnancy, Unplanned
  • Public Health
  • Young Adult

Substances

  • Contraceptive Agents
  • Contraceptives, Postcoital
  • Levonorgestrel