Sat Feb 4 23:34:08 SGT 2012  
    SHIM CLINIC
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Emergency Contraception | Shim Clinic, Singapore
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Summary

Emergency Contraception | 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

In vitro assessment of some sperm function following exposure to levonorgestrel in human fallopian tubes
Mon, 30 Jan 2012 05:00:00 +0100 | Reproductive Biology and Endocrinology
Conclusions: In a similar dose to that observed in serum following oral intake for EC, LNG had no effect on the number of motile spermatozoa recovered from the human fallopian tubes in vitro, on their adhesion to the tubal epithelium, distribution or AR rate. The possible effect of LNG as EC on sperm function remains poorly understood. (Source: Reproductive Biology and Endocrinology)

Copper intrauterine device for emergency contraception: clinical practice among contraceptive providers.
Thu, 26 Jan 2012 20:44:22 +0100 | Obstetrics and Gynecology
CONCLUSION: : Recommendation of the copper IUD for emergency contraception is rare, despite its high efficacy and long-lasting contraceptive benefits. Recommendation would require clinic flow and scheduling adjustments to allow same-day IUD insertions. Patient-centered and high-quality care for emergency contraception should include a discussion of the most effective method. LEVEL OF EVIDENCE: : III. PMID: 22270272 [PubMed - in process] (Source: Obstetrics and Gynecology)

Science, Politics, and Over-the-Counter Emergency Contraception [Viewpoint]
Tue, 24 Jan 2012 05:00:00 +0100 | JAMA
(Source: JAMA)

Access to Emergency Contraception for Adolescents [Research Letters]
Tue, 24 Jan 2012 05:00:00 +0100 | JAMA
(Source: JAMA)

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

Politics Vs. Science in the Plan B Decision
Wed, 21 Dec 2011 12:25:05 +0100 | Pharma Marketing News
HHS Secretary Sebelius focused on the fact that Teva's study did not contain data for all ages for which this product would be available for use. According to Tina Raine-Bennett, MD, MPH, of the Women's Health Research Institute at Kaiser Permanente Northern California, a principal investigator of the University of California-San Francisco study, it is unreasonable and virtually impossible to study the use of emergency contraception in 11- and 12-year-olds, because only a small fraction of them will have had sex by that age. (Source: Pharma Marketing News)

Researchers Find Misinformation About Emergency Contraception Common In Low-Income Neighborhoods
Wed, 21 Dec 2011 08:00:00 +0100 | Health News from Medical News Today
Researchers from Boston Medical Center (BMC) and Boston University School of Medicine (BUSM) have found that in low-income neighborhoods, misinformation about access to emergency contraception is a common occurrence. These findings appear as a research letter in the Dec. 19 on-line issue of the Journal of the American Medical Association. In 2009, the U.S. Food and Drug Administration facilitated access to emergency contraception among adolescents by making it available over-the-counter to individuals age 17 years and older... (Source: Health News from Medical News Today)

Pharmacies Mislead Teens on Morning-After ----
Tue, 20 Dec 2011 23:15:00 +0100 | Scientific American - Official RSS Feed
Women who live in low-income neighborhoods are more likely than their wealthier counterparts to get misinformation about emergency contraception from their local pharmacies, a new study finds. [More] (Source: Scientific American - Official RSS Feed)

Girls 17 and Older Often Denied Plan B (CME/CE)
Mon, 19 Dec 2011 17:43:11 +0100 | MedPage Today Primary Care
(MedPage Today) -- Girls who meet the age requirement for over-the-counter access to emergency contraception are often denied the so-called morning after ----, and denials are more common in poor neighborhoods, researchers found. (Source: MedPage Today Primary Care)


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