A 28-year-old woman requests emergency contraception 58 hours after unprotected intercourse. She has no contraindications to any method. Which of the following emergency contraceptive methods remains effective and should be offered?

• A Combined oestrogen-progestogen emergency contraception (Yuzpe regimen)
• B Levonorgestrel 1.5 mg single dose
• C Ulipristal acetate 30 mg single dose ✓
• D Cu-IUD insertion is the only remaining option as pills are ineffective beyond 72 hours

Explanation

Ulipristal acetate (UPA, EllaOne) is effective for emergency contraception up to 120 hours (5 days) after unprotected intercourse and is more effective than levonorgestrel (LNG) for the 72–120-hour window. At 58 hours, LNG is still within its licensed 72-hour window and retains some efficacy, but UPA provides greater efficacy at 58 hours than LNG. The Yuzpe regimen (option A) is less effective and more side-effect-prone than LNG and UPA, now largely obsolete. Option D is incorrect — UPA (and LNG if UPA unavailable) remains an option up to 72–120 hours; Cu-IUD (most effective overall) is an additional option but not the 'only' one.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.