Emergency Contraception

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]

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 ,[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 ,[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? ,[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]

Emergency Contraception

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Emergency Contraception