1960s

The sexual revolution
The sexual revolution was helped by the advent of the pill, giving women the option of control over their fertility. Regular use of oral contraception is over 99 per cent effective in preventing pregnancy. For those women who do not use regular contraception, EC was developed to prevent pregnancy after unprotected sexual intercourse (UPSI) or contraception failure.

1970s

New methods
In 1974, the Yuzpe regimen (combined oestrogen and progestogen) was the method of choice, but this was superseded by a progestogen-only EC regimen following a large, randomised controlled trial showing its better efficacy and acceptability.

In 1975, another method of EC was launched – the copper-bearing IUD or ‘coil’ and was used for regular contraception. The coil is now recognised as the most effective form of EC, as well as providing ongoing contraception as soon as it is inserted.

1980s

Further progression
In 1984, the combined oestrogen/progestogen EC pill was made available on prescription. For the first time, large numbers of women were able to access EC.

In 1985, EC was allowed to be provided to girls without telling their parents, providing they were judged to be able to understand the consequences. This made it easier for teenage girls to control their fertility and reduce the chances of teenage pregnancy.

1990s

Progestogen-only EC
A large, randomised controlled trial published in 1998 established better efficacy and acceptability than the Yuzpe regimen for a progestogen-only EC regimen – two doses of levonorgestrel taken 12 hours apart. Levonorgestrel became the EC method of choice and women suffered less nausea and sickness after taking it.

2000s

More options
In 2001, levonorgestrel became a P medicine for use in women over 16 years of age. The progestogen-only EC regimen originally consisted of two doses of levonorgestrel 750 micrograms taken 12 hours apart, but this was superseded in 2003 by a single dose of levonorgestrel 1500 micrograms. 

Ulipristal 30mg was launched in 2009 as a prescription medicine. It is licensed for EC for up to 120 hours (five days) after UPSI or contraceptive failure.

2005’s new pharmacy contract included EC as an enhanced service.

2010s

All change
2012 saw the first PGDs for ulipristal EC start to emerge.

In March 2014, the National Institute for Health and Care Excellence (NICE) published guidance on contraceptive services with a focus on young people up to the age of 25.

In June 2014, the Faculty of Sexual and Reproductive Healthcare (FSRH) produced an EC decision-making guide to support community pharmacists in choosing the most appropriate emergency contraception option.

In 2015, EllaOne (ulipristal 30mg) was granted a license for over-the-counter sale for any woman of childbearing age, including adolescents.

In March 2017, the FSRH launched new emergency contraception guidance and in April published updated guidance on quick-starting contraception. Beginning a contraceptive method at a time other than the start of the menstrual cycle is termed ‘quick starting’. With all quick started hormonal contraception, additional contraceptive precautions (condoms or abstinence) are required until the quick started method becomes effective. This may be required following emergency contraception.