Thu Feb 23 03:01:11 SGT 2012  
    SHIM CLINIC
168 Bedok South Avenue 3 #01-473
Singapore 460168
Tel: (+65) 6100 7446 (SHIM)
Fax: (+65) 6449 7446
24hr Answering Tel: (+65) 6333 5550 		Opening Hours
Monday to Friday: 9 am to 3 pm, 7 pm to 11 pm
Saturday & Sunday: 7 pm to 11 pm
Public Holidays: Closed
Last registration: half hour before closing time.
Walk-in clinic. Appointments not required.
Bring NRIC, Work Pass or Passport for registration.

Ella® | Shim Clinic, Singapore
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Summary

Ella® | Shim Clinic, Singapore: Emergency contraception. (EC) Emergency oral / morning-after / day-after / contraceptive / birth control pill (BCP) clinic, Singapore. Private and confidential service. Definitions, references, latest news.

Description

The morning-after / day-after emergency contraceptive is not available over the counter.
It is available only by prescription, after seeing a doctor.
Boyfriends cannot consult with the doctor on behalf of his girlfriend.
The girl herself must register to see the doctor.
Do not ask if we know of other clinics providing this medication. We are not a directory service.
It is in stock at Shim Clinic, NOW!

Situations where emergency contraception (EC) would be useful:

  • Unprotected sex:
    • "Condom broke"
    • "Condom slipped off"
    • "Didn't use a condom"
    • "Forgot to use a condom"
  • Other contraceptive failure
    • "Forgot to take contraceptive"
    • "Tried the pull-out method, but not sure if he pulled out in time"
    • "Tried the rhythm method, but worried that it is not reliable"

Emergency contraceptive formulations

Advice / points to note about taking emergency contraceptives:

  • One tablet should be ingested within 72 hours (3 days) following intercourse and another one 12 hours after taking the first tablet.
  • The emergency contraceptive is more effective the sooner it is taken after sex.
    • Within 24 hours, it prevents 95% of pregnancies.
    • Between 24-48 hours, it prevents 85% of pregnancies.
    • Between 48-72 hours, it prevents 58% of pregnancies.
    • Up to 5 days after intercourse, it has progressively decreasing effectiveness.
  • It is recommended that it should not be used more than twice in a month.
  • Other regular methods of contraception that may be considered are the use of condoms, combined oral contraceptives (COCs), and patch contraceptives.
  • It may cause a temporary disruption in the rhythm of the regular menstrual cycle. But if the next menstrual cycle does not come, then a pregnancy test should be done.
  • In a few people, it may cause some of the following side effects:
    • Headache
    • Dysmenorrhoea
    • Nausea
Sexual risk (of STD/HIV/pregnancy), and what you can do before and after exposure.

TimelineEvent / Available resources
Before exposure
STD / HIV exposure Unsafe sex / unprotected sex:
0-72 hours
2 weeks
1 month
  • HIV p24 antigen test
3 months
  • Rapid HIV test will be positive in 97% of infected individuals
    • HIV test cost is SG$60/= (HIV test only)
    • Oral fluid or finger prick blood sampling.
    • Results in 20 minutes.
  • STD testing
6 months
Anytime
  • Full/total/complete STD testing:
    • Men who practice insertive sex SG$497/=
    • Women who practice vaginal sex SG$737/= (includes Digene® HPV DNA & ThinPrep® test)
    • Either sex practicing anal sex SG$697/= (includes Digene® HPV DNA test)
    • Other variations - discuss with the doctor.
    • Hold your urine in your bladder for at least 4 hours.
  • STD treatment when STD symptoms appear.
  • Genital warts treatment/removal/cure

The morning-after / day-after emergency contraceptive is not available over the counter.
It is available only by prescription, after seeing a doctor.
Boyfriends cannot consult with the doctor on behalf of his girlfriend.
The girl herself must register to see the doctor.
Do not ask if we know of other clinics providing this medication. We are not a directory service.
It is in stock at Shim Clinic, NOW!

References

Latest News

Ulipristal acetate versus low-dose mifepristone for emergency contraception: a systematic review
Thu, 09 Feb 2012 03:36:54 +0100 | Contraception
The objective of this systematic review is to assess differences in efficacy and side effect profiles among ulipristal acetate and low-dose mifepristone. (Source: Contraception)

Oral Ulipristal Proves Highly Effective for Uterine FibroidsOral Ulipristal Proves Highly Effective for Uterine Fibroids
Thu, 02 Feb 2012 18:02:11 +0100 | Medscape Today Headlines
The selective progesterone receptor modulator ulipristal acetate reduced bleeding and fibroid size in 2 trials, offering gynecologists a new tool for treating uterine fibroids prior to surgery. Medscape Medical News (Source: Medscape Today Headlines)

RCTs: Ulipristal acetate for preoperative treatment of symptomatic uterine fibroids
Thu, 02 Feb 2012 05:00:00 +0100 | NeLM - News
Source: N Engl J Med Area: News The results of two RCTs examining the efficacy of the progesterone-receptor modulator ulipristal acetate for preoperative treatment of symptomatic uterine fibroids have been published in the New England Journal of Medicine.   The first study compared the efficacy and safety of oral ulipristal acetate for the treatment of symptomatic uterine fibroids before surgery with placebo in women who experienced excessive uterine bleeding (>100 on pictorial blood-loss assessment chart [PBAC, monthly scores range from 0 to >500, with higher numbers indicating more bleeding]) and anaemia (haemoglobin level of ?10.2 g/dl). They were randomised to treatment for up to 13 weeks with oral ulipristal acetate 5mg/d (n= 96) or 10 mg per day (n= 98) or placebo (...

Ulipristal Acetate Found Effective Against Uterine Fibroids in Two Studies
Thu, 02 Feb 2012 05:00:00 +0100 | Physician's First Watch current issue
(Source: Physician's First Watch current issue)

New Drug Treats Fibroids With Fewer Side Effects
Wed, 01 Feb 2012 22:25:52 +0100 | WebMD Health
The drug ulipristal acetate effectively controlled bleeding and shrunk uterine fibroids in two new studies. (Source: WebMD Health)

Ulipristal Acetate versus Placebo for Fibroid Treatment before Surgery
Wed, 01 Feb 2012 22:00:13 +0100 | New England Journal of Medicine
New England Journal of Medicine, Volume 366, Issue 5, Page 409-420, February 2012. (Source: New England Journal of Medicine)

Ulipristal Acetate versus Leuprolide Acetate for Uterine Fibroids
Wed, 01 Feb 2012 22:00:06 +0100 | New England Journal of Medicine
New England Journal of Medicine, Volume 366, Issue 5, Page 421-432, February 2012. (Source: New England Journal of Medicine)

Ulipristal acetate: a guide to its use in emergency contraception
Wed, 28 Dec 2011 10:06:25 +0100 | Drugs
(Source: Drugs)

European CHMP recommends approval of ulipristal acetate (Esmya) for pre-operative treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age
Fri, 16 Dec 2011 05:00:00 +0100 | NeLM - News
Source: European Medicines Agency (EMA) Area: News The European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) has recommended the approval of ulipristal acetate (Esmya 5mg tablet) for pre-operative treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age The duration of treatment is limited to 3 months. (Source: NeLM - News)


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