Hormonal emergency contraception works by preventing implantation of a fertilized ovum through changes in the endometrium, delaying ovulation or interfering with corpus luteum function. Studies indicate that hormonal emergency contraception is very effective.
Emergency contraception can be used at any time during the menstrual cycle. Earlier, small studies seemed to indicate that timing of the first dose within the first 72 h was not important, but it is now clear that both forms of oral ECPs are more effective if given in the first 24 h, with efficacy decreasing over the next 48. Despite this, it has been suggested that emergency contraception may be useful for up to five days. If an adolescent girl presents after three days, ECPs can be tried up to 120 h after intercourse, as long as she is informed that it has less chance of working, although an intrauterine contraceptive device (IUCD), if available, is a better option.
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