Items in AFP with MESH term: Contraception, Postcoital
Advance Provision for Emergency Oral Contraception - Cochrane for Clinicians
Sexual Assault of Women - Article
ABSTRACT: Sexual violence affects up to one third of women during their lifetime. Sexual assault is underreported, and more than one half of assaults are committed by someone known to the survivor. Although both men and women can be sexually assaulted, women are at greatest risk. Some groups are more vulnerable, including adolescents; survivors of childhood sexual or physical abuse; persons who are disabled; persons with substance abuse problems; sex workers; persons who are poor or homeless; and persons living in prisons, institutions, or areas of military conflict. Family physicians care for sexual assault survivors immediately and years after the assault. Immediate care includes the treatment of injuries, prophylaxis for sexually transmitted infections, administration of emergency contraception to prevent pregnancy, and the sensitive management of psychological issues. Family physicians should collect evidence for a “rape kit” only if they are experienced in treating persons who have been sexually assaulted because of the legal ramifications of improper collection and storage of evidence. Sexual assault may result in long-term mental and physical health problems. Presentations to the family physician may include self-destructive behaviors, chronic pelvic pain, and difficulty with pelvic examinations. Prevention of sexual assault is societal and should focus on public health education. Safety and support programs have been shown to reduce sexual assaults.
An Update on Emergency Contraception - Article
ABSTRACT: Emergency contraception decreases the risk of unintended pregnancy after unprotected sexual intercourse or after suspected failure of routine contraception (e.g., a condom breaking). Oral methods include combined contraceptive pills (i.e., Yuzpe method), single- or split-dose levonorgestrel, and ulipristal. The Yuzpe method and levonorgestrel are U.S. Food and Drug Administration–approved for use 72 hours postcoitus, whereas the newest method, ulipristal, is approved for up to 120 hours postcoitus. The copper intrauterine device may be used as emergency contraception up to seven days after unprotected intercourse. It is nonhormonal and has the added benefit of long-term contraception. Advanced provision of emergency contraception may be useful for all patients, and for persons using ulipristal because it is available only by prescription. Physicians should counsel patients on the use and effectiveness of emergency contraception, the methods available, and the benefits of routine and consistent contraception use.