hatcher ra, trussell j, nelson al, cates w, kowal d, policar m. contraceptive techology: twentieth revised edition. new york ny: ardent media, 2011. notes: 1 among typical couples who initiate use of a method (not necessarily for the first time), the percentage who experience an accidental pregnancy during the first year if they do not stop use for any other reason. estimates of the probability of pregnancy during the first year of typical use for spermicides, withdrawal, fertility awareness-based methods, the diaphragm, the male condom, the oral contraceptive pill, and depo-provera are taken from the 1995 national survey of family growth corrected for underreporting of abortion; see the text for the derivation of estimates for the other methods. 2 among couples who initiate use of a method (not necessarily for the first time) and who use it perfectly (both consistently and correctly), the percentage who experience an accidental pregnancy during the first year if they do not stop use for any other reason. see the text for the derivation of the estimate for each method. 3 among couples attempting to avoid pregnancy, the percentage who continue to use a method for 1 year. 4 the percentages becoming pregnant in columns (2) and (3) are based on data from populations where contraception is not used and from women who cease using contraception in order to become pregnant. among such populations, about 89% become pregnant within 1 year. this estimate was lowered slightly (to 85%) to represent the percentage who would become pregnant within 1 year among women now relying on reversible methods of contraception if they abandoned contraception altogether. 5 foams, creams, gels, vaginal suppositories, and vaginal film. 6 the ovulation and two day methods are based on evaluation of cervical mucus. the standard days method avoids intercourse on cycle days 8 through 19. the symptothermal method is a double-check method based on evaluation of cervical mucus to determine the first fertile day and evaluation of cervical mucus and temperature to determine the last fertile day. 7 without spermicides. 8 with spermicidal cream or jelly. 9 ella, plan b one-step and next choice are the only dedicated products specifically marketed for emergency contraception. the label for plan b one-step (one dose is 1 white pill) says to take the pill within 72 hours after unprotected intercourse. research has shown that all of the brands listed here are effective when used within 120 hours after unprotected sex. the label for next choice (one dose is 1 peach pill) says to take 1 pill within 72 hours after unprotected intercourse and another pill 12 hours later. research has shown that both pills can be taken at the same time with no decrease in efficacy or increase in side effects and that they are effective when used within 120 hours after unprotected sex. the fda has in addition declared the following 19 brands of oral contraceptives to be safe and effective for emergency contraception: ogestrel (1 dose is 2 white pills), nordette (1 dose is 4 light-orange pills), cryselle, levora, low-ogestrel, lo/ovral, or quasence (1 dose is 4 white pills), jolessa, portia, seasonale or trivora (1 dose is 4 pink pills), seasonique (1 dose is 4 light-blue-green pills), enpresse (one dose is 4 orange pills), lessina (1 dose is 5 pink pills), aviane or loseasonique (one dose is 5 orange pills), lutera or sronyx (one dose is 5 white pills), and lybrel (one dose is 6 yellow pills). 10 however, to maintain effective protection against pregnancy, another method of contraception must be used as soon as menstruation resumes, the frequency or duration of breastfeeds is reduced, bottle feeds are introduced, or the baby reaches 6 months of age. % of women experiencing an unintended pregnancy within the first year of use % of women continuing use at one year 3 method typical use 1 perfect use 2 (1) (2) (3) (4) no method 85 85 spermicides 5 28 18 42 fertility,awareness-based methods 24 47 standard days method twoday method 5 4 ovulation method 3 symptothermal method 6 0.4 withdrawal 22 4 46 sponge 36 parous women 24 20 nulliparous women 12 9 condom female (fc) 21 5 41 male 18 2 43 diaphragm 12 6 57 combined pill and progestin only pill 9 0.3 67 norelgestromin and ethinyl estradiol patch 9 0.3 67 nuvaring 9 0.3 67 depo-provera 6 0.2 56 intrauterine contraceptives paragard (copper t) mirena(lng) 0.8 0.2 0.6 0.2 78 80 implanon 0.05 0.05 84 female sterilization 0.5 0.5 100 male sterilization 0.15 0.10 100 jencycla tablets have not been studied for and are not indicated for use in emergency contraception.

erine. although symptoms of ectopic pregnancy should be watched for, a history of ectopic pregnancy need not be considered a contraindication to use of this contraceptive method. healthcare professionals should be alert to the possibility of an ectopic pregnancy in women who become pregnant or complain of lower abdominal pain while on progestin-only oral contraceptives. 2. delayed follicular atresia/ovarian cysts if follicular development occurs, atresia of the follicle is sometimes delayed and the follicle may continue to grow beyond the size it would attain in a normal cycle. generally these enlarged follicles disappear spontaneously. often they are asymptomatic; in some cases they are associated with mild abdominal pain. rarely they may twist or rupture, requiring surgical intervention. 3. irregular genital bleeding irregular menstrual patterns are common among women using progestin-only oral contraceptives. if genital bleeding is suggestive of infection, malignancy or other abnormal conditions, such nonpharmacologic causes should be ruled out. if prolonged amenorrhea occurs, the possibility of pregnancy should be evaluated. 4. carcinoma of the breast and reproductive organs some epidemiological studies of oral contraceptive users have reported an increased relative risk of developing breast cancer, particularly at a younger age and apparently related to duration of use. these studies have predominantly involved combined oral contraceptives and there is insufficient data to determine whether the use of pops similarly increases the risk. a meta-analysis of 54 studies found a small increase in the frequency of having breast cancer diagnosed for women who were currently using combined oral contraceptives or had used them within the past ten years. this increase in the frequency of breast cancer diagnosis, within ten years of stopping use, was generally accounted for by cancers localized to the breast. there was no increase in the frequency of having breast cancer diagnosed ten or more years after cessation of use. women with breast cancer should not use oral contraceptives because the role of female hormones in breast cancer has not been fully determined. some studies suggest that oral contraceptive use has been associated with an increase in the risk of cervical intraepithelial neoplasia in some populations of women. however, there continues to be controversy about the extent to which such findings may be due to differences in sexual behavior and other factors. there is insufficient data to determine whether the use of pops increases the risk of developing cervical intraepithelial neoplasia. 5. hepatic neoplasia benign hepatic adenomas are associated with combined oral contraceptive use, although the incidence of benign tumors is rare in the united states. rupture of benign, hepatic adenomas may cause death through intra-abdominal hemorrhage. studies have shown an increased risk of developing hepatocellular carcinoma in combined oral contraceptive users. however, these cancers are rare in the u.s. there is insufficient data to determine whether pops increase the risk of developing hepatic neoplasia.

opped; immune system disorders: anaphylactic/anaphylactoid reaction, hypersensitivity ; hepatobiliary disorders: hepatitis, jaundice cholestatic; skin and subcutaneous tissue disorders: alopecia, rash, rash pruritic.