Emergency Contraception

This document updates previous Faculty of Sexual & Reproductive Healthcare (FSRH) guidance and aims to summarise the available evidence on emergency contraception (EC). The guidance is intended for use by health professionals providing EC. This document was updated in December 2020.

A new study (Edelman 2022) adds to the evidence around use of LNG-EC by those with higher weight/BMI but does not give a clear enough picture to inform any change in guidance.

A recently-published literature review considers the evidence around mechanism of action of levonorgestrel oral emergency contraception (LNG-EC). The findings support current FSRH guidance on emergency contraception, and are reassuring for those with ethical concerns about post-ovulation effects.

Evidence from new study supports the existing FSRH recommendation that commencement of hormonal contraception should be delayed for 5 days after UPA-EC. Published 28/8/2018.

The European Medicines Agency (EMA) is currently reviewing the safety of use of Esmya® (ulipristal acetate) for management of uterine fibroids. This review follows reports of a very small number of cases worldwide of serious liver injury in women using Esmya. Until the review process is complete, temporary restrictions have been placed on commencing treatment with Esmya and guidelines for monitoring liver function in women already taking Esmya have been introduced. The EMA recommendations are available at: http://www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/2018/02/news_detail_002902.jsp&mid=WC0b01ac058004d5c1