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Levonorgestrel Emergency Contraception

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Levonorgestrel Emergency Contraception

Key Points

  • Levonorgestrel EC (Plan B) is most effective when taken within 72 hours of unprotected intercourse.
  • It works primarily by delaying or inhibiting ovulation, not by preventing implantation.
  • Effectiveness decreases with time: most effective within 24 hours, still useful up to 120 hours.
  • It does not protect against sexually transmitted infections and is not for routine contraception.
  • At higher body weight, levonorgestrel EC effectiveness may decline; discuss alternative EC options when indicated.

Mechanism

Levonorgestrel inhibits or delays ovulation by suppressing the LH surge. It may also alter cervical mucus and endometrial receptivity, but is NOT an abortifacient — it does not affect an established pregnancy.

Key Nursing Considerations

  • Confirm timing: most effective within 72 hours, available up to 120 hours.
  • Assess for contraindications: current pregnancy (will not terminate), severe hepatic disease.
  • Teach that nausea, vomiting, and irregular bleeding are common side effects.
  • Advise follow-up pregnancy test if next period is more than 1 week late.
  • Counsel that efficacy may be lower at higher body weight and discuss ulipristal or copper-IUD pathways when clinically appropriate.
  • Counsel on regular contraception methods to prevent future need for emergency contraception.

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