Approach to selection of emergency contraception after unprotected intercourse

EC: emergency contraception; UPI: unprotected intercourse, which includes (1) no contraception was used, (2) a method was used imperfectly, (3) intercourse was forced without use of contraception; IUD: intrauterine device; BMI: body mass index.
* Information on IUD device types, candidates, and device selection can be found in related UpToDate content.
¶ Pregnancy rates are less than 1% for the copper TCu380A and levonorgestrel 52 mg IUDs, up to 1.8% for ulipristal acetate, and up to 2.6% for oral levonorgestrel.
Δ Treatment with ulipristal acetate typically requires a prescription. In the United States, oral levonorgestrel is available over the counter for individuals age 17 and older. Individuals younger than age 17 may require a prescription, which varies by state.
◊ A pregnancy test is not required prior to starting medication EC. However, if pregnancy testing is readily available, it is reasonable to perform for those with high likelihood of pregnancy.
§ Pericoital contraception includes internal and external condoms, diaphragms, cervical caps, spermicidal sponges, and vaginal spermicide.
¥ Hormonal contraception includes combined estrogen-progestin contraceptives (oral pill, patch, vaginal ring, injection) and progestin-only methods (etonogestrel implant, depo-medroxyprogesterone acetate injection, and progestin-only oral pills).
‡ Contraceptive failure can include missing more than one dose of oral contraceptive pills; failure to resume the depo provera injection, patch, or vaginal ring at the correct time; had a diaphragm, cervical cap, or contraceptive sponge slip; or had a condom break.