A 16-year-old girl seeks private consultation about emergency contraception within 96 hours. She has severe asthma and is taking systemic steroids for an exacerbation. Which of the following is MOST appropriate advice?

A 16-year-old girl seeks private consultation about emergency contraception within 96 hours. She has severe asthma and is taking systemic steroids for an exacerbation. Which of the following is MOST appropriate advice?

• A. Advise taking a levonorgestrel emergency contraceptive pill.
• B. Signpost to the GP or sexual health clinic to get a copper IUD fitted.
• C. Advise using a barrier method only for contraception.
• D. Advise delaying contraception until symptoms subside.

Answer: (B)

In emergency contraception, the most effective option within 5 days after unprotected sex is a copper intrauterine device. It works by creating an inhospitable environment for fertilization and implantation, and it also serves as ongoing contraception for as long as it remains in place. This makes it the best choice when someone is within 96 hours of unprotected intercourse, because it offers the highest pregnancy protection compared with progestin-only pills, whose effectiveness is lower and time-limited. The patient’s severe asthma and systemic steroids do not pose a contraindication to copper IUD use, so proceeding to arrange insertion is appropriate. In this case, the best course is to signpost to the GP or a sexual health clinic to assess eligibility and arrange copper IUD fitting. This ensures timely access to the insertion, which can be done within the 5-day window and provides immediate and ongoing protection. Options involving a progestin emergency pill are less effective in this window and do not offer the same long-term contraception benefit. Delaying contraception or using a barrier method alone would not provide the strongest protection, especially given the time frame.

In emergency contraception, the most effective option within 5 days after unprotected sex is a copper intrauterine device. It works by creating an inhospitable environment for fertilization and implantation, and it also serves as ongoing contraception for as long as it remains in place. This makes it the best choice when someone is within 96 hours of unprotected intercourse, because it offers the highest pregnancy protection compared with progestin-only pills, whose effectiveness is lower and time-limited.

The patient’s severe asthma and systemic steroids do not pose a contraindication to copper IUD use, so proceeding to arrange insertion is appropriate. In this case, the best course is to signpost to the GP or a sexual health clinic to assess eligibility and arrange copper IUD fitting. This ensures timely access to the insertion, which can be done within the 5-day window and provides immediate and ongoing protection.

Options involving a progestin emergency pill are less effective in this window and do not offer the same long-term contraception benefit. Delaying contraception or using a barrier method alone would not provide the strongest protection, especially given the time frame.