Emergency hormonal contraception usage in genitourinary medicine clinic attenders.
OBJECTIVE
To assess the indications for usage of emergency hormonal contraception amongst a population of London genitourinary medicine clinic attenders.


METHODS
In a prospective study, 150 consecutive women receiving emergency hormonal contraception (EHC) were enrolled. The attending doctor completed a questionnaire of patient details and prescribed EHC with prophylactic prochlorperazine. Follow-up was arranged three weeks later, at which time outcomes and side-effects of therapy were recorded. For those women who did not reattended as planned case notes were reviewed at three months.


RESULTS
Of 150 women surveyed, 100 (66%) reported contraceptive method failure, 48 (32%) had used no contraception at the time of last sexual intercourse and two requested EHC after sexual assault. Ninety three (62%) reported condom failure, 7 (5%) oral contraceptive pill failure. Seventy five (50%) had used EHC before (range 1-10 times). Seventy one (47%) women reattended within three months. Five (3.3%) of the 150 women were pregnant; none of these cases had experienced nausea or vomiting whilst taking EHC. Side-effects were reported by 22 (31%) of the 71 patients who reattended. Nine (6%) women had been followed-up in the family planning advisory clinic. Of the 71 women who reattended, 39 (55%) reported that their preferred future method of contraception would be condoms. Of the 150 women 19 (13%) underwent tests for sexually transmissible infections within one month of presentation.


CONCLUSIONS
EHC usage in this population was associated with a failure rate of at least 3.3% and an overall side effect rate of 31%. Despite requests for emergency contraception because of condom failure many elected to continue using condoms as their preferred method of contraception. The majority of women (53%) did not return for follow-up or family planning advice, and so we believe that future contraceptive plans must be addressed at the time EHC is prescribed.
Evans
J K
JK
Ambrose King Centre, Royal London, Hospital, Whitechapel, UK.
Holmes
A
A
Browning
M
M
Forster
G E
GE
D000293:Adolescent; D000328:Adult; D003268:Contraception Behavior; D003282:Contraceptives, Postcoital, Hormonal / Q000008:administration & dosage* / Q000009:adverse effects; D004630:Emergencies; D005193:Family Planning Services; D005260:Female; D006801:Humans; D010044:Outpatient Clinics, Hospital; D010349:Patient Compliance; D011247:Pregnancy; D011446:Prospective Studies; D017211:Treatment Failure
D003282:Contraceptives, Postcoital, Hormonal