[4] Turok DK, Godfrey EM, Wojdyla D, Dermish A, Torres L, Wu SC. A copper-releasing IUD is a safe and effective method of contraception especially for a parous woman living in a faithful, stable relationship. There is little difference in the effectiveness or safety of various IUDs. How does it work? [3] Cleland K, Zhu H, Goldstuck N, Cheng L, Trussell J. Senior Science Writer, University of Utah Health . All hormonal IUDs approved in the U.S. contain a synthetic version of the hormone progesterone called levonorgestrel (LNG). The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Date Revision 29 May 2017 Table 1(page 6). When an LNG IUD is placed at the time LNG EC pills are taken, pregnancy rates within 2 weeks have been less . However, if there is concern of luteal phase pregnancy, a pregnancy test should be completed within 3 weeks of taking EC. LNG IUD is not approved for use as emergency contraception. Emergency Contraception (EC), also known as postcoital contraception or the morning after pill refers to the contraceptive methods that women can use to prevent pregnancy after unprotected sexual intercourse.Access to EC is essential for ensuring women's reproductive health. Emergency Contraception. EC emergency contraception ECP emergency contraceptive pill ETGetonogestrel FAB fertility awareness-based (method) GDG Guideline Development Group GRADE Grading of Recommendations Assessment, Development and Evaluation IM intramuscular IUD intrauterine device LNG levonorgestrel LNG-ECP levonorgestrel emergency contraceptive pill New to this edition: New methods Combined hormonal contraception: Qlaira Implant: Nexplanon Emergency contraception: ulipristal acetate New regimens Extended and continuous combined hormonal contraception Quick starting and bridging? More effective the sooner it is taken. Sensitivity analysis of (a) best and (b) worst-case scenarios and use of the drop-out event as a study end-point. (eds) Contraceptive Technology. However, unlike copper IUDs, little or no research had been conducted on the LNG IUD use as an emergency contraceptive device. Emergency contraceptive options include: "morning after pills", the copper IUD, and some birth control pills when taken in a specific way. implants, emergency contraceptive pills (ECPs), copper-bearing intrauterine devices (Cu-IUDs), levonorgestrel-releasing IUDs (LNG-IUDs), copper-IUD for emergency contraception (E-IUD), progesterone-releasing vaginal ring (PVR), barrier methods (BARR), fertility awareness-based methods (FAB), lactational Ella [Prescribing information]. “This is all about increasing access and options for people,” Turok says. War Against Planned Parenthood Hurts Women, Win-win for both treatment and prevention, Menopause, mood, mental acuity, and hormone therapy, Reproductive tract infections, sexually transmitted infections, or sexually transmitted diseases: “a rose by any other name…”, Be alert to VTE in hormonal contraceptive users, LARC among teens increased 15-fold, but not enough, Free tools: Easy access to the US Medical Eligibility Criteria for Contraceptive Use, Alcohol consumption when pregnancy is unwanted or unintended, Latest Data on Contraceptive Use in the United States, LateBreaker sampler from Contraceptive Technology conference, Emergency Contraceptive Pill Efficacy and BMI/Body Weight, Handout on Unintended Pregnancy and Contraceptive Choice. Other effective methods such as the LNG taken in high They ruled out pregnancy in the remaining 7% based on survey information and clinical reports. T he authors conducted a prospective cohort study comparing the copper T380A intrauterine device (IUD) and oral levonorgestrel (1.5 mg LNG) for emergency contraception (EC) among 542 women at two family planning clinics in Salt Lake City, Utah, between November 2009 and July 2010. emergency contraceptive pills, the effectiveness of IUDs does not vary based on a woman's weight. Found insideWritten by the foremost authority in the field, this volume is a comprehensive review of the multifaceted phenomenon of hepatotoxicity. However, unlike copper IUDs, little or no research had been conducted on the LNG IUD use as an emergency contraceptive device. 3. A LNG IUD may be referred to as an intrauterine system (IUS) and can be referred to by the mg of levonorgestrel in its reservoir. - Within 7 days of the start of her period if the woman uses a progestogen implant or a LNG-IUD or a progestogen-only injectable. - Within 7 days of the start of her period if the woman uses a progestogen implant or a LNG-IUD or a progestogen-only injectable. IUD (copper coil) as emergency contraception. 4 = A condition that represents an unacceptable health risk if the contraceptive method is used. Levonorgestrel (LNG) is a progestin-only emergency contraception pill (ECP) that should be taken orally as soon as possible, within a 72-h window following sexual intercourse, although some studies suggest moderate efficacy up to 120 h post-coitus [11,12,13,14].It is sold in the United States as Plan B One-Step® (1.5 mg) as a single dose and is sold under several generic labels, including . . There are different forms of EC. Jatlaoui TC, Riley H, Curtis KM. . "Successor to The Essentials of Contreceptive Technology"--Cover. As a result, few, if any, medical providers have used LNG IUDs for . However, unlike copper IUDs, little or no research had been conducted on the LNG IUD use as an emergency contraceptive device. It is a highly effective, immediate, and cost-effective ongoing method of birth control for up to ten years post-insertion. Use of LNG > 72 hours would be unlicensed but supported by Clinical Effectiveness Unit for up to 96 hours. Sensitivity analysis of (a) best and (b) worst-case scenarios and use of the drop-out event as a study end-point. 37 Full PDFs related to this paper. Example: each of the 2 doses can be made by taking: 4 tablets of either Nordette ®, Microgynon ® 30 ED, Monofeme ® or Levlen ® ED or. Has detailed health history (includes menstrual, sexual, contraception, personal health and family history) that does not [2] Studies are now underway to assess the efficacy of the LNG IUD alone as EC, as the copper IUD is now used as EC. Women's Health Use of female condoms can provide protection from transmission of STDs, although data are limited. More effective the sooner it is taken. Which method of contraception best suits your patient's needs? Contraceptive technology has exploded at breakneck speed. The options now available can bewilder patients who need practical advice for family planning. This volume is devoted to General Gynecology, which covers care of the female patient outside of pregnancy or during the initial weeks of pregnancy. The eligibility criteria for interval Cu-IUD insertion also apply for the insertion of Cu-IUDs as emergency contraception (Box J1) (Table J1). Morristown, NJ; 2010. 16; Cost may be a consideration - LNG is $18-25, UPA emergency contraception is available on private prescription for around $40-$50. Copyright © 2021 Contraceptive Technology 2021. Many women who receive an IUD for emergency contraception retain the IUD as their primary form of contraception. Background: Emergency contraception (EC) is a method to be used in the case of unprotected sexual intercourse, failure of a regular contraceptive method and after rape to try to prevent an unintended pregnancy.They include copper intrauterine devices (IUD) and different types of pills like estrogen-progestin combination pill, levonorgestrel containing pills (LNG). This could be welcome news to your patients, as more women in this study chose a LNG IUD with oral LNG EC (121 women) over the copper IUD (67 women) at the time of their visit. Levonorgestrel (LNG) is a progestin that has been used for contraception for more than 50 years. (eds) Contraceptive Technology. New York, NY: Ayer Company Publishers, Inc., in production. With the objective of limiting the individual family size to just one or two children, most women spend the larger part of their reproductive years attempting to avoid an unwanted or unplanned pregnancy. Now, in a first-of-its-kind study, University of Utah Health scientists found that hormonal IUDs were comparable to copper IUDs for use as emergency contraceptives. Updated to incude the 2016 UK Medical Eligibility Criteria for contraceptive use, this book is the ideal practical reference guide for family physicians and other healthcare professionals concerned with contraceptive provision. As a result, few, if any, medical providers have used LNG IUDs for this purpose. . It works as an emergency contraceptive when inserted within 1-5 days after unprotected sex. For most of us, having sex is much easier than talking about sex, especially its least pleasant consequences.” – Ina Park MD, Strange Bedfellows. Email: doug.dollemore@hsc.utah.edu We averaged these two . There are more and more options for emergency contraception (EC) available for patients. Rules to Practice By: Safety First and Cleanliness is Close to. Should be taken within 72 hours of intercourse. “This finding is exciting because it will give people more options for both emergency and ongoing contraception and decrease barriers to same-day IUD placement when patients want one.”. Desires an IUD for long-term contraception. In the Contraceptive CHOICE Project, continuation rates with the LNG-IUD and the copper-containing IUD were 88% and 85%, re-spectively, at 1 year, 79% and 77% at 2 years, and 52% and 56% at 5 years.13,14 In other studies in-volving various populations in the United States, 12-month IUD continuation rates of 87 to 89% regular hormonal contraceptive methods. Copper IUD for Emergency Contraception. Carten ML, Kiser JJ, Kwara A, Mawhinney S, Cu-Uvin S. Pharmacokinetic interactions between the hormonal emergency contraception, levonorgestrel (Plan B), and efavirenz. The success of Assisted Reproductive Technology is critically dependent upon the use of well optimized protocols, based upon sound scientific reasoning, empirical observations and evidence of clinical efficacy. David Turok. This study shows that use of a backup method is not needed after placement of either a copper T380A or LNG 52 mg IUD. 21st edition. For example, Mirena and Liletta would be called LNG IUS 52. . We can offer clients three long-acting reversible methods including a copper IUD, an LNG IUS, or a contraceptive implant. Research from the University of Utah and Planned Parenthood shows evidence that the hormonal intrauterine device or LNG-IUD is an effective option for both long-term and emergency contraception. READ PAPER. Emergency contraception (EC), or postcoital contraception, offers an opportunity to prevent pregnancy when unprotected or inadequately protected sex occurs. The LNG-IUD is under investigation for use as emergency contraception but should not be used for . on emergency contraception contraception.. If she thinks she may be pregnant, she should see her clinician as soon as possible, whether or not she plans to continue the pregnancy. In: Hatcher RA, Nelson A, Trussell J, et al. “While I assumed the hormonal IUD would work for emergency contraception, I was surprised to see it worked just as well as the copper IUD,” says Lori Gawron, M.D., M.P.H., a study co-author and an assistant professor in the Department of Obstetrics and Gynecology at U of U Health. The TCu380A is the most effective method of EC—more effective than use of ECPs— and is highly effective for up to 7 days from unprotected inter­course. According to a study, ulipristal acetate EC pills have a failure rate between 0.9 to 2.1 per cent, while the failure rate of levonorgestrel-based EC pills is between 0.6 to 3.1 per cent. If the day of ovulation can be estimated, the Cu-IUD also can be inserted >5 days after sexual intercourse as long as insertion does not occur >5 days after ovulation. 21st edition. This authoritative guide to contraception gives highly practical, evidence-based advice, with enough detail to inform effective clinical practice. All clinical services and programs are part of University of Utah Health Hospitals and Clinics. Frequently repeated ECP use may be harmful for women with conditions classified as 2, 3 or 4 for contraceptives containing hormones. OBJECTIVE(S): This study compares 1-year intrauterine device (IUD) continuation among women presenting for emergency contraception (EC) and initiating the copper (Cu T380A) IUD or the levonorgestrel (LNG) 52 mg IUD plus 1.5 mg oral LNG. The first-year typical use effectiveness rates for the LNG-IUD and the CuT380a are 0.1% and 0.8%, respectively. Case-based “As an emergency contraceptive, it appears to be no worse than a copper IUD and is way better than the morning-after pill.”, He adds, “And, unlike emergency contraception pills, hormonal IUDs can continue to provide highly effective contraception for up to seven years.”. Saving Lives, Protecting People, Classifications for Fertility Awareness–Based Methods, Summary of Classifications for Hormonal Contraceptive Methods and Intrauterine Devices, Personal Characteristics and Reproductive History, http://dx.doi.org/10.1016/j.contraception.2015.11.001, https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022474s000lbl.pdf, http://dx.doi.org/10.1016/j.contraception.2016.05.002, National Center for Chronic Disease Prevention and Health Promotion, CDC Contraceptive Guidance for Health Care Providers, US Medical Eligiblity Criteria (US MEC) for Contraceptive Use, Summary Chart: Hormonal Contraceptive Methods and Intrauterine Devices, U.S. Department of Health & Human Services, a. The premier reference in family planning for clinicians, “…even with the ubiquity of STIs…most people (even health care providers) simply don’t feel comfortable discussing them. 3. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Two low-dose levonorgestrel intrauterine contraceptive systems: a randomized ontrolled trial. Excess breast cancer deaths after COVID-19, Contraception for patients with medical conditions, New 13-Cycle Vaginal Contraceptive System, The Future of Family Planning in Post-COVID America, New ASCCP Guidelines: Implications for FP, On the alert: mood disorders during 2020 stressors, Challenges old and new during the pandemic, Reproductive health in the time of Covid-19, Missed Pills: The Problem That Hasn’t Gone Away, Find the “yes! There have been exciting new developments and research related to currently available contraceptives. [6] Winner B, Peipert JF, Zhao Q, et al. The researchers obtained urine pregnancy tests from about 93% of the participants. Classifications for emergency contraceptive pills (ECPs) are given for ulipristal acetate (UPA), levonorgestrel (LNG), and combined oral contraceptives (COCs). Copper intrauterine device (IUD) The most effective method of emergency contraception is a copper intrauterine device (IUD), which is inserted by a doctor within 7 days of unprotected intercourse. Abbreviations: EC, emergency contraception; IUD, intrauterine device; LNG, oral levonorgestrel Just as it is important for pharmacists to help patients select EC, it is also important for pharmacists to recognize when it may be most appropriate to refer the patient to a provider. According to the researchers, LNG IUDs may become an attractive choice because they are used widely and are already FDA-approved for use as birth control. [5] Dean G and Schwarz EB. CDC twenty four seven. . Hum Reprod 2012;27:1994-2000. Key: Cu IUD, copper IUD; LNG IUD+, same-day 52 mg levonorgestrel IUD plus 1.5 mg oral levonorgestrel. Contraceptive CHOICE Project: Study Details 12 ELIGIBLE Tiered Contraceptive Counseling LNG-IUS Cu-IUD Implant DMPA Pills Patch Ring Other Secura G, Am J Obstet& Gynecol2010 Madden T, Contraception 2012 Principles of Gender-Specific Medicine examines how normal human biology differs between men and women and how the diagnosis and treatment of disease differs as a function of gender. Found insideFurthermore, it is now widely recog nized that no drug, chemical or even natural substance is completely devoid of risk. Nowhere has this issue been the subject of more controversy than with steroidal contraceptive drugs. Oral progesterone-only emergency contraception (POEC) - levonorgestrel (LNG) The traditional 'morning after pill'. The failure rate as an emergency contraceptive appears to be very much lower than the cumulative rate at 7 years for continuous use of the TCu 380A of 2.5 per 100 woman years of use, 39 suggesting a different immediate mechanism of action of the copper IUD when being used for emergency contraception compared to use as LARC contraception. Good news on the family planning home front! In this randomized, noninferiority trial among patients seeking emergency contraception after at least one episode of unprotected intercourse within five days of presentation, the levonorgestrel 52-mg intrauterine device (IUD) was noninferior to the copper T30A IUD at preventing pregnancy one month after IUD insertion. While currently available by prescription only, the copper IUD provides ongoing secure birth control. A pilot study of the Copper T380A IUD and oral levonorgestrel for emergency contraception. IUDs have been safely used to prevent pregnancy by millions of women around the world, and have been used as emergency contraception for at least 35 years. The Cu-IUD also can be inserted within 5 days of the first act of unprotected sexual intercourse as an emergency contraceptive. This edition includes new and updated information on new oral contraceptive pills, transdermal and vaginal delivery, post-pregnancy contraception, use of Essure for sterilization, and uses of contraceptives for non-contraceptive indications ... Copper Intrauterine Device (IUD) The most effective method of emergency contraception is a copper intrauterine device (IUD), which is inserted by a doctor within 7 days of unprotected intercourse. To address this concern, the U of U Health researchers decided to test the effectiveness of LNG IUDs versus copper IUDs. Found inside"This chapter has one chance to make a first impression on the reader. in emergency contraception, Abortion in the U.S.: safe, declining, and under threat, Breast cancer still a small risk with some hormonal contraceptives, Viruses in semen potentially transmissible, Don’t Abstain from Your Role in Abstinence, Teens births declining but geographic ‘hotspots’ defy trend, Online Medical Abortion Service Effective and Safe, PMDD: Genetic clues may lead to improved treatment, Breast cancer risk when there is a family history, Body weight link to breast and endometrial cancers (and 11 others), Managing implant users’ bleeding and spotting, Zika virus fears prompt increased request for abortion in nations outlawing abortions, Opioid use epidemic among reproductive-age women. Approximately half of LNG-IUD users are likely . All of the participants had unprotected intercourse at least once in the previous five days. The efficacy of the Copper T IUD is not affected by oral emergency contraception options. Patricia Murphy . 23 Based on the available data, both the CuT380a 5,7 and the LNG-IUD 6 are expected to have similar contraceptive effectiveness, whether inserted immediately or 2-8 weeks after a first-trimester abortion. This book provides a question-based synopsis of family planning issues. In addition to Dr. Turok and Dr. Gawron, Alexandra Gero, Rebecca Simmons, Jennifer Kaiser, Gregory Stoddard, Corrine Sexsmith, and Jessica Sanders of University of Utah Health contributed to this study. UPA is the only oral method licensed for 72 to 120 hours and is the preferred method if elligible. In: Hatcher RA, Nelson A, Trussell J, et al. Contraception 2016;93:93–112. The last new method of emergency contraception was approved for use by the Food & Drug Administration nearly 15 years ago. Sara Simonsen. d - Repeated ECP use is an indication that the woman requires further counselling on other contraceptive options. . (LNG-IUDs) Handout #12: LNG-IUD Section of Family Planning a Global Handbook for Providers. …highly effective contraception for up to 12 years after insertion . The LNG- IUD is classified as category 3 due to the slight increased risk of thrombosis in this already high risk population. However, the incidence of pregnancy with the use of the levonorgestrel IUD for emergency contraception in this trial (0.3%; 95% CI, 0.01 to 1.7) appears to compare favorably with that reported . In a randomized noninferiority trial, women seeking emergency contraception were assigned to receive either a levonorgestrel 52-mg IUD (N=317) or a copper T380A IUD (N=321). Contraception Today is the definitive introductory guide to contraceptive advice. The eighth edition of this bestselling pocketbook summarizes all available methods of contraception and the various factors to be considered in using them. Additional contraception (condoms) is not required if the method is started: - With a Cu-IUD. In . Hormonal contraception, Postcoital contraception during breastfeeding, An intrauterine device as postcoital contraception and interventions. LNG IUD is not approved for use as emergency contraception. Cu-IUDs, UPA, LNG, and COCs do not protect against sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), and women using these methods should be counseled that consistent and correct use of the male latex condom reduces the risk for transmission of HIV and other STDs. New York, NY: Ayer Company Publishers, Inc., in production. Cu-IUD: Combination oral contraceptive pills: Dose: 1.5 mg: 0.75 mg (2 pills taken once) 30 mg: . It updates the 2nd edition, and summarises the main recommendations of an Expert Working Group meeting held at WHO in Geneva, October 2003. Of course, the copper IUD remains a well-tested and very effective option for those needing an emergency contraceptive. Classifications for emergency contraceptive pills (ECPs) are given for ulipristal acetate (UPA), levonorgestrel (LNG), and combined oral contraceptives (COCs). The emergency contraceptive pill contains 1.5mg of a progestogen hormone called . Study design: This prospective study followed women for 1 year after choosing either the copper T380 IUD or oral LNG for EC. The latest edition summarizes all available methods of contraception and the various factors to be considered in using them. The risk of pregnancy after using morning-after pills is about 2%, Turok says. Found insideAround 100 common clinical problems feature in quick-read cases, alongside evidence-based recommendations and current guidelines. Emergency Contraceptive Pills (ECPs) Training for Pharmacists; Intrauterine Devices (IUDs) Lactational Amenorrhea Method (LAM) . After taking EC pills, a period may start a few days earlier or later than usual. Adverse events between the two groups were similar. It is more effective in preventing pregnancy and it will work as a long term contraceptive. The study, “The Levonorgestrel vs. Copper Intrauterine Device for Emergency Contraception,” appears in the New England Journal of Medicine. Over a three-year period beginning in August 2016, they recruited more than 700 people, ages 18 to 35, who were seeking emergency contraception at six Utah Planned Parenthood health clinics. Clinical Considerations An essential quick reference for the office, the hospital, or anywhere, this book provides all the instructions you need to handle common, non-life-threatening emergencies with speed and expertise. Not receiving immunosuppressive therapy, a. Found insideThis annual report assesses the nation's health by presenting trends and current information on selected measures of morbidity, mortality, health care utilization and access, health risk factors, prevention, health insurance, and personal ... A pilot study of the Copper T380A IUD . and” rather than “no” or “but”, Digital Family Planning: the Future is Now, Contraceptive efficacy: understanding how user and method characteristics play their part, Strategizing treatment for chronic heavy menstrual bleeding, Untangling the literature on obesity and contraception, Menstrual exacerbation of other medical conditions, From Princeton University: Thomas James Trussell (1949-2018), Selecting a Method When Guidance Isn’t Clear-cut, Healthcare in the Time of Digital Expansion, The Scoop on Two New FDA-Approved Contraceptive Methods, Pregnancy of unknown location—meeting the challenge, Big “yes” (with caveats) to CHCs during perimenopause, The role of IUDs (LNG IUDs, too!) Emergency contraceptive pills (ECPs)—sometimes simply referred to as emergency contraceptives (ECs) or the morning-after pill—are medications intended to disrupt or delay ovulation or fertilization, which are necessary for pregnancy. All IUDs can also be used by people with contraindications to estrogen. Research News In comparison, the 0.1% risk of pregnancy with copper IUDs is far less. Desires an IUD for long-term contraception. The Levonorgestrel vs. Copper Intrauterine Device (IUD) for Emergency Contraception 2. Epub May 24, 2016. A pilot study of the Copper T380A IUD and oral levonorgestrel for emergency contraception. However, unlike copper IUDs, little or no research had been conducted on the LNG IUD use as an emergency contraceptive device. There are three types of emergency contraception available in Australia: Levonorgestrel EC (a tablet) Ulipristal acetate EC (a tablet) The copper IUD; Levonogestrel - EC. Not only do we have levonorgestrel (LNG) 1.5mg pills, ulipristal acetate 30mg pills, and the copper IUD (Cu-IUD), recent studies have shown that the 52mg progestin IUD can be used for EC up to 5 days after unprotected intercourse. If concern exists about sexually transmitted infection (STI) (e.g. One study found almost 95% of women who received an IUD as emergency contraception were still using this method 12 months later.9 The participants were randomly assigned to receive either an LNG or copper IUD. “These findings support using hormonal IUDs as a safe and viable alternative for women seeking to prevent pregnancies up to five days after intercourse,” says David Turok, M.D., M.P.H., lead author of the study and an associate professor in the Department of Obstetrics and Gynecology at U of U Health. To address this concern, the U of U Health researchers decided to test the effectiveness of LNG IUDs versus copper IUDs. Australian women have three options for emergency contraception: two types of oral pills (levonorgestrel [LNG]-containing pill and ulipristal acetate [UPA]) and the copper intrauterine device (IUD). Published on: 3 December 2020 File size: 1150kb PDF File type: Current Clinical Guidance Author: FSRH Clinical Effectiveness Unit This document updates previous Faculty of Sexual & Reproductive Healthcare (FSRH) guidance and aims to summarise the available evidence on emergency contraception (EC). Although all forms of one-pill LNG emergency contraception products are approved for over-the . The study was powered to detect a 6% difference in pregnancy rates within the year . Should be taken within 72 hours of intercourse. The efficacy of intrauterine devices for emergency contraception: a systematic review of 35 years of experience. However, when the time of ovulation can be estimated, the Cu-IUD can be inserted beyond 5 days after intercourse, if necessary, as long as the insertion does not occur >5 days after ovulation. While currently available by prescription only, the copper IUD provides ongoing secure birth control. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Emergency contraception. Safety and effectiveness data for emergency contraceptive pills among women with obesity: a systematic review. The most effective EC is the copper-bearing intrauterine device (Cu-IUD), but oral EC methods are more commonly used and include a single dose of either levonorgestrel (1.5 mg) or ulipristal acetate (30 mg). In this study, the risk with hormonal IUDs was 0.3% and statistically was not less effective than the copper. That’s because of distinct differences in the appearance of these IUDs. There are several LARC options available for use in the United States. If a copper IUD is used for emergency contraception, no additional contraceptive protection is needed. Abbreviations: BMI = body mass index; CHC = combined hormonal contraceptive; COC = combined oral contraceptive; Cu-IUD = copper-containing intrauterine device; ECP = emergency contraceptive pill; HIV = human immunodeficiency virus; IUD = intrauterine device; LNG = levonorgestrel; NA = not applicable; POC = progestin-only contraceptive; POP = progestin-only pill; STD = sexually transmitted disease; UPA = ulipristal acetate.