A 5-years experience of the Centre on Emergency Contraception P.R. Abakarova V. N. Prilepskaya T.N. Bebneva (Research Centre of Obstetrics, Gynecology and Perinatology)

Induced Abortions in Russian Federation (by 1000 fertility women, ) Data of the Ministry of Health

Emergency Contraception service may be provided by:  gynecologists  family planning centers  youth counseling centers  general practitioners (family doctors)

The Centre on Emergency Contraception was created in the Research Centre of Obstetrics, Gynecology & Perinatology of the Russian Academy of Medical Sciences, Russian Society of Contraception by supporting Gedeon Richter in 2000.

Centre on Emergency Contraception Information Unit Counseling Unit Trainings on EC are held for different medical Doctors every month 1570 have been trained Counseling on ECCounseling on EC follow-up follow-up Help in choice of plannedHelp in choice of planned contraception contraception hot line counseling hot line counseling

1410 women, aged from 16 to 35, have been counseled on emergency contraception for the period of 5 years have been counseled on emergency contraception for the period of 5 years.

EC Center clients: 40% - one sexual partner  40% - one sexual partner  12.2% - more than one partner  34.9% - first sexual contact  10% - unintended sex  2.8% - sexual abuse

Reasons of the unprotected sexual contacts : failure of condom 37,2% - failure of condom 37,2% - failure of withdrawal 40,9% - failure of withdrawal 40,9% - sex without contraceptives 13% - sex without contraceptives 13% - incorrect using of OC 6% - incorrect using of OC 6% - sexual abuse 2,8% - sexual abuse 2,8%

Yuzpe method Ovidon  ethynilestradiol 50 mkg  levonorgestrel 250 mkg The protocol: 1-dose: 2 tablets not later than 72 hours after unprotected sex 2-dose: 2 tablets in 12 hours after the first doze

Yuzpe method Efficacy 463 women have been treated by Estrogen- progestagen pills containing 50mkg ethynilestradiol mkg levonorgestrel (Ovidon) Efficacy 94,8% Side effects:  Sickness - 32,6%  Vomiting - 12,3%  Mastalgy - 20,7%  Headache - 23,1%

Postinor Contains 0.75 mg of levonorgestrel in 1 pill One pill should be taken not later than 72 hrs after unprotected sex sex, the 2 nd 2 nd pill – 12 hrs after the 1 st 1 st one.Gestagens

women have been treated by levonorgestrel in the dose of 0.75 mg (Postinor) Efficacy 98,6% Side effects: Sickness – 17,9% Vomiting - 5,3% Mastalgy - 15,9% Headache - 13,3% Efficacy of EC gestagen method

Escapelle Contains 1,5 mg of levonorgestrel in 1 pill One pill should be taken not later than 96 hrs since sexual contact Gestagens

Menstruation onset in two methods of EC

Intrauterine contraception Intrauterine contraception was recommended to 37 patients coming to the Centre later than 72 hrs after unprotected sex (CuT-380A)

Intrauterine contraceptive device was inserted on days 4-5 after unprotected sexual contact Efficacy - 97,3% Side effects: Pain - 29,7 % Long plentiful menstruation - 16,2 %

Counseling Protocol and EC management date of the last menstrual period and exclusion of possible pregnancy  date of the last menstrual period and exclusion of possible pregnancy  time interval since unprotected sex  counseling about possible side effects  follow-up and planned contraception choosing

« ANY « ANY METHOD OF EMERGENCY CONTRACEPTION IS SAFER THAN INDUCED ABORTION» (WHO, 1997)

Thank Thank you for attention!