Issues in emergency contraception for the adolescent

  • SK Kwa
  • Sivalingam N


Before prescribing emergency contraception, it is important to establish that unprotected coital intercourse has indeed taken place. Young naive adolescents sometimes think that heavy petting, touching, kissing or oral sex can lead to pregnancy. Conversely, sexual encounter without penetration but with ejaculation around the female genitalia can occasionally result in pregnancy. Next, it is important to ensure that she is not already pregnant because emergency contraception will not be effective then. Following that, it is important to determine the duration lapsed since the unprotected coitus. This is to determine whether emergency contraception is still possible and the appropriate emergency contraceptive method to recommend. Emergency contraception with high-dose combined (oestrogen & progestogen) contraceptive pills or progestin-only pills are effective up to 72 hours after unprotected coitus with effectiveness highest if used as soon as possible after coitus.1-3 Emergency contraceptive pills (ECP) should not be given to women who are already pregnant as the pills would no longer be effective. Otherwise, there are no other contraindications unlike regular hormonal contraception.1,3,4 Levonorgestrel (LNG) pills can still be prescribed up to 120 hours after coitus,1,3,4 but its effectiveness falls rapidly after 72 hours (copied from article)


Trussell J, Raymond EG. Emergency contraception: a last chance to prevent unintended pregnancy. Office of Population Research at Princeton University. 2012.

Randomised controlled trial of levonorgestrel versus the Yuzpe regimen of combined oral contraceptives for emergency contraception. Task Force on Postovulatory Methods of Fertility Regulation. Lancet. 1998;352(9126):428-33.

World Health Organization. Special Programme of Research, Development and Research Training in Human Reproduction. Levonorgestrel for emergency contraception. 2005.

Kathiravan C, Sivalingam N. Emergency contraception pill - controversies and use. Med J Malaysia. 2007;62(1):90-2.

von Hertzen H, Piaggo G, Ding J, et al. Low dose mifepristone and two regimes of levonorgestrel for emergency contraception: a WHO multicentre randomised trial. Lancet. 2002;360(9348):1803-10.

Gainer E, Kenfack B, Mboudou E, et al. Menstrual bleeding patterns following levonorgestrel emergency contraception. Contraception. 2006;74(2):118-24.

Raymond EG, Goldberg A, Trussell J, et al. Bleeding patterns after use of levonorgestrel emergency contraceptive pills. Contraception. 2006;73(4):376-81.

World Health Organization. Special Programme of Research, Development and Research Training in Human Reproduction. Fact sheet on the safety of levonorgestrel-alone emergency contraceptive pills (LNG ECPs). 2010.

International Consortium for Emergency Contraception (ICEC) and International Federa­tion of Gynecology & Obstetrics (FIGO). Mechanism of action. How do levonorgestrel-only emergency contraceptive pills (LNG ECPs) prevent pregnancy? 2011.

Carr-Gregg MR, Enderby KC, Grover SR. Risk-taking behaviour of young women in Australia: screening for health-risk behaviours. Med J Aust. 2003;178(12):601-4.

How to Cite
KwaS., & NS. (2012). Issues in emergency contraception for the adolescent. Malaysian Family Physician, 7(1), 4. Retrieved from
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