## Emergency Contraception — Efficacy and Timing **Copper IUD (Copper T) insertion within 5 days** is the most effective emergency contraceptive method, with a failure rate of only **0.1–0.2%** (Pearl Index), making it superior to all hormonal methods. ### Why Copper T is Best: - **Highest efficacy**: >99% effective if inserted within 5 days of unprotected intercourse - **Mechanism**: Creates a hostile endometrial environment, prevents implantation - **Can be used as ongoing contraception** after emergency use - **No systemic side effects** compared to hormonal methods - **Effective even at 36 hours** (well within the 5-day window) ### Comparison with Other Methods: | Method | Efficacy | Window | Failure Rate | |--------|----------|--------|---------------| | **Copper T** | **99.2%** | **5 days** | **0.1–0.2%** | | Levonorgestrel | 60–90% | 72 hours | 1–2% | | Mifepristone | 85–90% | 72 hours | 1–2% | | Yuzpe regimen | 50–80% | 72 hours | 2–3% | **Key Point:** At 36 hours post-intercourse, the patient is well within the optimal window for Copper T insertion, which offers superior protection compared to all hormonal alternatives. **Clinical Pearl:** Copper IUD is the gold standard emergency contraceptive and should be offered as first-line if the patient has no contraindications (no active infection, no pregnancy).
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