The answer

The guidance Vicky is referring to is the document published by the influential and well-regarded Faculty of Sexual and Reproductive Healthcare (FSRH), which is part of the Royal College of Obstetricians and Gynaecologists (RCOG). The paper – an update of guidelines from 2012 – is intended for use by all healthcare professionals involved in the provision of emergency contraception (EC), and basically states:

• Copper containing intrauterine devices (IUDs) are recommended first line for EC, because they are highly effective, regardless of any other medication the woman is taking, and also provide immediately effective ongoing contraception
• Oral EC (also known as emergency hormonal contraception or EHC) is an option in pharmacy for women who have had unprotected sexual intercourse (UPSI) and don’t wish to conceive, assuming they meet the criteria laid down for sale or supply
• Ulipristal is usually the best EHC option, as it can be taken up to 120 hours after UPSI, and needs no dose adjustment for women who are overweight or obese
• Levonorgestrel is better for women who are at risk of pregnancy because of missed contraceptive pills, who want to start a hormonal contraceptive immediately after EHC, or who are on enzyme-inducing medicines
• All women enquiring about EC should be counselled on STIs and regular contraception.