Considerations

This 22-year-old nulliparous woman is approximately midcycle and had an episode of unprotected intercourse the night before. She is a candidate for EC, which usually is effective if given within 72 hr of coitus. Recent studies suggest that EC may be effective up to 120 hr after coitus. Options include high-dose estrogen and progestin pills taken now and in 12 hr, or high-dose progestin-on I y therapy. The advantage of the progestin-only treatment is less nausea and vomiting. She does not have contraindications for this therapy (e.g., deep venous thrombosis, liver disease, or hypertension). Another potential treatment includes insertion of an intrauterine contraceptive device.

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