The bigger picture

The FSRH guidelines highlight some important updates to practice, namely:

• The standard EC dose of levonorgestrel appears less effective in women who have a body mass index over 26kg/m2 or weigh more than 70kg, but this does not appear to be an issue with ulipristal
• Both EHCs interact with enzyme-inducing drugs, but only levonorgestrel is licensed at double the usual dose to compensate.

The document also states that while an IUD is first line, if a woman is referred for a fitting, oral EC should be provided anyway, just in case the appointment is delayed or the woman changes her mind about the contraceptive method.