Thu Feb 23 03:04:48 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.

Estinor® | Shim Clinic, Singapore

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Summary

Estinor® | 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

Oral contraceptives containing drospirenone for premenstrual syndrome.
Sun, 19 Feb 2012 18:00:03 +0100 | Cochrane Database of Systematic Reviews
CONCLUSIONS: Drospirenone 3 mg plus ethinyl estradiol 20 μg may help treat premenstrual symptoms in women with severe symptoms, that is, premenstrual dysphoric disorder. The placebo also had a large effect. We do not know whether the combined oral contraceptive works after three cycles, helps women with less severe symptoms, or is better than other oral contraceptives. Larger and longer trials of higher quality are needed to address these issues. Trials should follow CONSORT guidelines. PMID: 22336820 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Progestogens and membrane-initiated effects on the proliferation of human breast cancer cells.
Wed, 15 Feb 2012 05:00:00 +0100 | Climacteric
Conclusion Some synthetic progestins trigger a proliferative response of PGRMC1-overexpressed MCF-7 cancer cells. The effect of progestogens on breast cancer tumorigenesis may clearly depend on the specific pharmacology of the various synthetic progestins. PMID: 22335423 [PubMed - as supplied by publisher] (Source: Climacteric)

The availability of behind-the-counter emergency contraception in Atlanta, GA: a comparison of national pharmacy chain policies and their implementation at local stores
Thu, 09 Feb 2012 03:36:55 +0100 | Contraception
To assess company policy on dispensing practices of levonorgestrel-based emergency contraceptive ----- (EC) among national pharmacy companies and local stores' compliance with these policies. (Source: Contraception)

Incidence of pregnancy after use of emergency contraception in sexually assaulted women
Thu, 09 Feb 2012 03:36:55 +0100 | Contraception
This study aims to determine the pregnancy rate among victims of sexual assault who received a single 1.5-mg dose of levonorgestrel as emergency contraception (LNG-EC). In this retrospective descriptive study, charts were reviewed of sexual assault victims seen by our Violence Intervention Program in an urban county hospital between January 2006 and April 2008. Inclusion criteria include women aged 12–39 years who received LNG-EC within 120 h of sexual assault with documentation of a negative urine pregnancy test at the initial visit and with urine pregnancy test results available from the 6-week follow-up visit. The confidence interval (CI) for rape-related pregnancy in our study is based on the binomial distribution. (Source: Contraception)

LNG IUD removals when the strings are not present: a case series
Thu, 09 Feb 2012 03:36:55 +0100 | Contraception
This study evaluates levonorgestrel intrauterine devices (LNG IUDs) that were removed per patient request when strings were not visible and assesses the length of the IUD strings. (Source: Contraception)

Postoperative Levonorgestrel-Releasing Intrauterine System for Pelvic Endometriosis-Related Pain: A Randomized Controlled Trial.
Mon, 06 Feb 2012 05:00:00 +0100 | Obstetrics and Gynecology
CONCLUSION:: The levonorgestrel-releasing intrauterine system is effective and well accepted for long-term therapy after conservative surgery for patients with moderate to severe pain related to endometriosis. It can improve the patient's quality of life, including physical and mental health. CLINICAL TRIAL REGISTRATION:: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00455845. LEVEL OF EVIDENCE:: I. PMID: 22314873 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)

Effect of Ethinyl estradiol/ Levonorgestrel combined oral contraceptive on the activity of Cytochrome P4503A in obese women.
Thu, 02 Feb 2012 05:00:00 +0100 | British Journal of Clinical Pharmacology
Conclusions:  Although we hypothesized that obesity exposure might amplify the impact on CYP3A4/5 activity in COC users, we found that this was not the case. This finding is reassuring regarding potential additional drug‐drug interactions in obese COC users as CYP3A4/5 is a major player in the metabolism of many marketed drugs.© 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society (Source: British Journal of Clinical Pharmacology)

Subfertile effects of quinestrol and levonorgestrel in male rats.
Wed, 01 Feb 2012 05:00:00 +0100 | Reproduction, Fertility, and Development
Authors: Liu M, Wan X, Yin Y, Li YX, Sun F, Zhang Z, Wang YL Abstract The contraceptive regimen consisting of levonorgestrel and quinestrol (EP-1) has been shown to be effective in several types of wild rodents. In the present study, we investigated the effect of EP-1 and its two components on fertility and spermatogenesis to elucidate the mechanisms underlying its contraceptive effect. Sprague-Dawley rats were treated with 0.33mgkg(-1) quinestrol (E group), 0.67mgkg(-1) levonorgestrel (P group) or their combination (EP group) for 7 days and then killed on Days 21 or 42 after treatment for tissue analysis. On Day 21, the weight of the cauda epididymis decreased significantly, while the weight of the adrenal gland increased significantly in the E and EP groups compared with the weig...

New Equilibrium Autoclave for Determining Solubility and Melting Point of Solid Solute in Supercritical Fluids. 1. Determination of Solubility of Levonorgestrel in Supercritical Carbon Dioxide
Tue, 31 Jan 2012 14:06:56 +0100 | Industrial and Engineering Chemical Research
Industrial & Engineering Chemistry ResearchDOI: 10.1021/ie201785w (Source: Industrial and Engineering Chemical Research)


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