Emergency contraception

Hitna kontracepcija podrazumijeva metode kontracepcije koje žene mogu koristiti nakon nezaštićenog spolnog odnosa, zatajenja korištene metode kontracepcije ili nepravilnog korištenja kontracepcije, a sa svrhom sprječavanja nastanka neželjenih trudnoća. U Europskoj Uniji odobrene su hormonske i nehormonske metode hitne kontracepcije. Hormonalne metode, koje uključuju oralne hitne kontraceptive s levonorgestrelom i ulipristal acetatom, sada su dostupne u ljekarnama bez recepta u gotovo svim zemljama Europske Unije. Ulipristal acetat je učinkovitiji u sprječavanju trudnoće od levonorgestrela te je odobren za korištenje unutar 120 sati nakon nezaštićenog spolnog odnosa. Najučinkovitija metoda hitne kontracepcije je intrauterini uložak s bakrom, koji nakon postavljanja može biti zadržan unutar maternice kao visokoučinkovita, nehormonalna metoda dugotrajne kontracepcije i do 10 godina. Mehanizam djelovanja oralnih hitnih kontraceptiva s levonorgestrelom i ulipristal acetatom je odgoda ovulacije. Ove metode hitne kontracepcije nemaju učinak na implantaciju. Bakar, iz intrauterinog uloška s bakrom, ometa oplodnju, ali može spriječiti i implantaciju oplođene jajne stanice. Ne postoje kontraindikacije za primjenu oralnih hitnih kontraceptiva, osim preosjetljivosti na neki od sastojaka. Kontraindikacije za inserciju intrauterinog uloška s bakrom za hitnu kontracepciju jednake su kao i pri rutinskom postavljanju u kontracepcijske svrhe. Dob i nuliparitet nisu kontraindikacije za primjenu intrauterinog uloška s bakrom. Omogućavanjem dostupnosti oralnih hitnih kontraceptiva s levonorgestrelom i ulipristal acetatom, kao i edukacijom žena o njihovom načinu korištenja, očekuje se javnozdravstveni doprinos hitne kontracepcije u smislu smanjenja stope neželjenih trudnoća i posljedičnih namjernih pobačaja.Emergency contraception refers to contraceptive methods that women can use to prevent unwanted pregnancies after unprotected sexual intercourse, contraceptive failure or incorrect use of contraceptives. Hormonal and non-hormonal emergency contraceptive methods have been approved in the European Union. Hormonal methods, which include emergency contraceptive pills with levonorgestrel and ulipristal acetate, are now available over-the-counter in pharmacies in almost every country in the European Union. Ulipristal acetate is more efficacious in pregnancy prevention than levonorgestrel, and it is approved for use up to 120 hours after sexual intercourse. The most effective method of emergency contraception is the copper intrauterine device, which can be left inside the uterus for up to 10 years after insertion for highly efficacious, hormone-free long-term contraception. The mechanism of action of oral emergency contraceptives with levonorgestrel and ulipristal acetate is delay of ovulation. Those emergency contraceptive methods do not affect implantation. Copper from copper intrauterine devices interferes with fertilization, but may also prevent implantation of fertilized ova. There are no medical contraindications to oral emergency contraceptives use except hypersensitivity to one of the ingredients. Contraindications to copper intrauterine device insertion for emergency contraception are the same as those for routine insertion for contraceptive use. Age and nulliparity are not contraindications for usage of Cu-IUDs. Facilitating the availability of oral emergency contraceptives with levonorgestrel and ulipristal acetate, as well as educating women about their mode of action, is expected to result in a contribution of emergency contraception to public health in terms of reducing unwanted pregnancy rates and subsequent intentional abortions