A 24-year-old woman visits the pharmacy requesting emergency contraception. Her last period was 10 days ago and unprotected intercourse occurred approximately 60 hours ago. She prefers an oral option and a single-dose method is acceptable. Which is the most appropriate emergency contraception option for this patient?

• A. Levonorgestrel 1.5 mg single dose
• B. Combined oral contraceptive emergency regimen
• C. Ulipristal acetate 30 mg single dose
• D. No option available; advise waiting for next period

Answer: (C)

Emergency contraception aims to prevent pregnancy by delaying ovulation and interfering with the process around the time of fertilization. Ulipristal acetate is a single-dose oral option that acts as a selective progesterone receptor modulator to delay ovulation, even when the LH surge is near. This makes it more reliable than other options in the late follicular phase and up to five days after intercourse, with less drop in efficacy across BMI ranges.

In this scenario, about 60 hours have passed since unprotected sex, and the last period was 10 days ago, placing the patient in a window where ovulation could be approaching. Delaying ovulation with ulipristal acetate provides stronger protection than levonorgestrel alone in this timing, so a single 30 mg dose of ulipristal acetate is the most appropriate choice. Combined oral contraceptive regimens aren’t as effective or safe for emergency use, and waiting for the next period offers no immediate protection.