Recommendations for Contraceptive Use
		Oral Contraceptives as Emergency Contraceptive Pills

Recommendations	Rationale
a) Either a full cycle of 21 hormonal pills may be provided or a woman can complete the cycle from which she took the ECPs. However, if high dose COCs (50 mcg EE) were used, completing the pill pack from which the ECPs were taken is not recommended.	a) There is no medical evidence indicating that less than a full cycle of COCs should be provided after ECP use. The length of the COC cycle is arbitrary.
b) Some providers recommend that a non-hormonal back-up method (e.g., abstinence, condoms) be used for seven days.	b) Use of COCs for seven days suppresses ovulation. Smith SK, Kirkman RJ, Arce BB, McNeilly AS, Loudon NB, Baird DT. The effect of deliberate omission of Trinordiol or Microgynon on the hypothalamo-pituitary-ovarian axis. Contraception 1986;34(5):513-22. Molloy BG, Coulson KA, Lee JM, Watters JK. "Missed pill" conception: a fact or fiction? British Medical Journal, Clinical Research Edition 1985;290(6480):1474-5.
c) Linking ECP use to long term use of COCs is helpful to women desiring COCs for contraception.	c) Because the woman has just used ECPs, the provider can be reasonably sure the woman is not pregnant. There is only a 2% risk of pregnancy with one-time use of ECPs. Trussell J, Stewart F. The effectiveness of postcoital hormonal contraception. Family Planning Perspectives 1992;24(6):262-4.

Any part of Recommendations for Updating Selected Practices in Contraceptive Use may be reproduced or adapted to meet local needs without prior permission from the TG/CWG Secretariat, provided the TG/CWG is acknowledged and the material is made available free of charge or at cost.