For a woman presenting within five days of unprotected intercourse who wants emergency contraception and has no contraindication, the copper intrauterine device is the most effective option and the only one that also provides ongoing contraception from the same visit. Oral methods are what most women are offered, but none matches it.
Oral emergency contraception loses efficacy at higher body weight; the copper device does not share that limitation. It can be placed up to five days after intercourse, or up to five days after the earliest estimated ovulation, and can stay in place for years if the woman wishes.
Where an intrauterine device is declined or unavailable, an oral agent is the fallback — not the default. Framing it that way at the point of counselling is the single change that most improves emergency contraception.
- Offer the copper intrauterine device first to anyone within 5 days who wants emergency contraception and has no contraindication.
- Effectiveness of oral emergency contraception falls with higher body weight; the copper device does not.
- It can be placed up to 5 days after intercourse, or up to 5 days after the earliest estimated ovulation.
- It also provides years of ongoing contraception in the same visit if the woman chooses to keep it.
Why it matters
Oral emergency contraception is what most women are offered, yet the copper device outperforms every pill and solves contraception going forward in one visit.
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