All are used as emergency contraception except
**Core Concept:** Emergency contraception is the use of hormonal or non-hormonal methods to prevent pregnancy within a short time frame after unprotected sexual intercourse or failure of a regular contraceptive method.
**Why the Correct Answer is Right:** Option D, levonorgestrel, is a progestin hormone that is the active ingredient in commonly used emergency contraceptives like YAZ, YAZ PLUS, and NORTHCAP. This progestin is the key component in these products' effectiveness as they act by inhibiting ovulation and increasing cervical mucus viscosity to prevent sperm entry.
**Why Each Wrong Option is Incorrect:**
A. Option A, ethinylestradiol, is a synthetic estrogen that is part of combined oral contraceptives (COCs). COCs contain both estrogens (like ethinylestradiol) and progestins (like levonorgestrel) and are widely used for contraception. In contrast to emergency contraception, COCs work through multiple mechanisms including inhibiting ovulation, thickening cervical mucus, and reducing uterine receptivity for implantation.
B. Option B, progestogens, are a group of steroids that include progestins (e.g., levonorgestrel) and progesterone. Progestins are used in emergency contraceptives, while progesterone is a hormone involved in the luteal phase of the menstrual cycle and is not effective for emergency contraception.
C. Option C, estrogens, are a group of steroid hormones that include estradiol and ethinylestradiol. As mentioned earlier, COCs contain both estrogens and progestins, making them effective for contraception but not emergency contraception.
**Clinical Pearl:** Emergency contraceptives, like levonorgestrel-based pills, provide a brief window for post-coital contraception within 120 hours (5 days) after unprotected sexual intercourse. Using these pills soon after unprotected intercourse can significantly reduce the risk of pregnancy.
**Correct Answer:** D. Progestogens, specifically levonorgestrel, is the correct answer as it is the active component in emergency contraceptives.