- What is Emergency Contraception?
- Is Emergency Contraception Safe?
- Who Can Use Emergency Contraception?
- Methods of Emergency Contraception
- How Does Emergency Contraception Work?
- In Which Situations Should You Use Emergency Contraception?
- What Kind of Emergency Contraception Is Best for You?
- How Should I Take an Emergency Contraceptive Pill?
- Effectiveness of Emergency Contraception
- Who Shouldn’t Use ECP?
- When Can We Say That Emergency Contraception Has Failed?
- Medication That Can Make ECP Less Effective
- Emergency Contraception Side Effects
- When Should You Call the Doctor?
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Unwanted pregnancies can be difficult to go through and the best method of relief at this juncture is emergency contraception. It can help you prevent the risk of pregnancy when taken within the right time frame and truly comes as a medical boon to many couples.
What is Emergency Contraception?
As the name suggests, emergency contraception is used when you have engaged in unprotected sex or if other methods of contraception did not work effectively. They should be used at the earliest after unprotected sex. It is important to remember that these should be used only when required in an emergency and not be made a regular contraception alternative.
Is Emergency Contraception Safe?
Yes. Emergency contraception is largely considered to be safe for most women. There have been no reports of serious ramifications after the use of emergency contraception. However, if you are on any other medications, it is important that you inquire with your doctor if it is safe to use emergency contraception (ECP).
Who Can Use Emergency Contraception?
Any girl who has reached the reproductive age and has engaged in unprotected sex can use emergency contraception. There is no age limit on the use of any form of emergency contraception unless there is an underlying medical condition that requires special attention.
Methods of Emergency Contraception
There are primarily two methods of emergency contraception.
1. ParaGard IUD Or Copper IUD
This is an intrauterine device that is inserted into your uterus. This can be used up to 5 days after having unprotected sex. The IUD is also a long-term contraceptive option that can work for about 10 to 12 years.
2. Contraceptive Pills
These emergency pills are of two kinds:
- Pills with ulipristal acetate
There is currently only one brand called Ella that offers these pills. Such pills also need a doctor’s prescription and should be used within 5 days or 120 hours after unprotected sex. The effectiveness of these pills remains the same even on the 5th
- Pills with levonorgestrel
These pills are best taken immediately after having unprotected sex. Their effectiveness depends on how soon they are consumed. However, for they should be taken at least within 72 hours or 3 days of unprotected sex. Plan B One-Step, Take Action, After Pill, I-pill, etc, are some of the brands with contraceptive pills containing levonorgestrel.
How Does Emergency Contraception Work?
Emergency contraception pills usually work by delaying ovulation. This essentially means that they are preventing fertilization by blocking the eggs from being released by the ovary. Levonorgestrel pills delay ovulation but in cases where the implantation of the egg and fertilization have already taken place, it does not stop the pregnancy.
Pills with ulipristal acetate delay ovulation but may also prevent the fertilized egg from being implanted in the uterus, thus avoiding pregnancy. Hence, these work for up to 5 days to prevent pregnancy, the period of time that the egg takes to get fertilized and implant.
The copper IUD makes it harder for sperms to swim through and reach the egg, hence it preventing pregnancy
In Which Situations Should You Use Emergency Contraception?
Emergency contraception is ideal if you do not want to end up with an unwanted pregnancy for any of the following reasons.
- Your partner’s condom broke or was defective.
- Your partner did not pull out in time(The pull-out method is not effective)
- You missed out on taking birth control pill or other using contraceptive methods like patches or rings. Also, if you had applied the patch on a wrong day.
- You miscalculated your safe period
- You engaged in unprotected sex without any birth control method
- If the diaphragm or the cervical cap slips out of its place or if you have removed it too early.
- If your IUD or hormonal contraceptive slips out of place.
What Kind of Emergency Contraception Is Best for You?
The kind of emergency contraception that is best for you depends on a few factors like
- The day on which you had unprotected sex
- Your BMI or height and weight
- Your history of pill or oral contraceptive usage
- Your breastfeeding status
- Access to the ECP
- Any medications you are on
- Your pregnancy status
While it is best to use the most effective methods of emergency contraception methods, IUDs and Ella are not available easily. IUD has to be inserted by a doctor or nurse and Ella is a prescription drug and cannot be purchased over the counter.
Plan B or other levonorgestrel pills are over the counter pills that do not require a prescription. While they can be about 88% to 95% effective when taken within 72 hours of unprotected sex, they are not as effective as Ella or IUD.
However, it is important to remember that if you were on birth control pills, ring, patch or the birth control shot, Ella will not be as effective. In such cases, levonorgestrel pills work better. Also, do not take pills like Plan B and Ella together as they can cancel out the effect.
The key to getting the best result from emergency contraception is to use it at the earliest interval.
How Should I Take an Emergency Contraceptive Pill?
Emergency contraceptive pills are taken orally immediately after unprotected sex. Levonorgestrel pills should be taken within 72 hours of unprotected sex and ulipristal acetate pills like Ella can be taken within 120 hours after unprotected sex. In case you vomit within two to three hours after taking the pill, you can consult your doctor about taking another dosage.
Effectiveness of Emergency Contraception
Plan B, when taken within 72 hours after unprotected sex, can prevent 85% of the unwanted pregnancies. However, these pills become less effective in overweight women and do not work efficiently in women over 165 pounds or 75 kg.
Ella’s effectiveness in preventing pregnancies can last for up to 120 hours and works just as well on the 5th day as it works on the first. Also, emergency contraceptive pills will not prevent pregnancy if you have unprotected sex after you take them. You will have to take another dose to avoid pregnancy. But, it is important to note that emergency contraceptives should not be used as a regular contraceptive method. There are other effective regular contraceptives that work well for most women.
IUDs have a 99% success rate in preventing unwanted pregnancy when used within 5 days unprotected sex. These also offer long-term protection. However, not all women are eligible to get an IUD.
It is important to remember that there is no emergency contraceptive that offers 100% protection. Hence, safe sex practices using protection is always encouraged.
Who Shouldn’t Use ECP?
Emergency contraceptives are generally safe for most women. A few instances when they shouldn’t be used are as follows.
- Plan B does not have any effect when you are already pregnant. Hence there is no reason for pregnant women to use it. However, if used, it does no harm to the fetus.
- Ella should not be used by pregnant women as there is not enough research to know its effects. It should also be noted that breastfeeding women should not use Ella as the effects are unknown.
- Pregnant women should not use IUD as it can increase their risk of infection.
- Women who were subjected to sexual assault should not use IUD as it may increase the risk of infections like gonorrhoea and Chlamydia.
- Women with pelvic inflammatory diseases, cervical cancer, puerperal sepsis, or vaginal bleeding that is unexplained should also avoid using IUD.
- Plan B is also not effective in women weighing over 75kg as their liver produces a lot of enzymes that metabolize drugs faster reducing the effectiveness of the pill.
When Can We Say That Emergency Contraception Has Failed?
If taken on time and the right way, emergency contraception has a good rate of success. However, if you miss your periods and test positive on the pregnancy test, then the ECP might have failed. Instances in which they can fail are listed below.
|Method Of ECP||Failure Rate||Possible Reasons For Failure|
|Plan B (levonorgestrel pills)||11% (If taken within 24 hours failure rate is around 5%)||– If the pill is taken after 72 hours
– If you had already ovulated
– If you are overweight (over 75 kg)
– You’ve vomited within two to three hours of taking the pill
|Ella||1.3 % (As per a study in 2010)||– If you were on birth control pills, the patch or ring
– If you start hormonal birth control within 5 days after taking Ella
– If you vomit the pill within two to three hours of taking it
|Copper IUD||1 %||· When inserted after 5 days of unprotected sex, in which case the sperm has already fertilized the egg.|
Medication That Can Make ECP Less Effective
Certain medications are known to make ECP pills less effective and these include even some herbal remedies. St. John’s Wort is a herb that can significantly reduce the effectiveness of ECP pills. Antibiotics like rifampin, barbiturates, griseofulvin which is an antifungal drug and certain HIV drugs can also interrupt the efficacy of ECP drugs. Anti-epileptic drugs and drugs administered for seizures can also render emergency contraceptive pills ineffective in most cases.
Emergency Contraception Side Effects
The common side effects are emergency contraception include:
- A headache
- Abdominal pain
- Changes in the menstrual cycle
- Heavier or lighter blood flow than usual
- Breast pain
When Should You Call the Doctor?
After taking the pill, you will need to consult your doctor if you miss your period and suspect that you are pregnant. Also, ensure to consult a doctor if you have severe abdominal cramps or notice that you have irregular bleeding for over a week. If you have used an IUD, consult your doctor in case you experience any discomfort.
If you have contracted any sexually transmitted diseases, it is best to visit a doctor and get treated on time.
1. Is copper UID Effective for Emergency Contraception?
Yes. Copper IUD is one of the most effective emergency contraception methods and provides about 99% success rate when used within 5 days of unprotected sex.
2. Does Emergency Contraception Provide Protection Against STDs?
No. Emergency contraception does not provide any protection against STDs. In order to prevent contracting sexually transmitted diseases, it is recommended that you take the right precautions and use a condom before intercourse every time. You and your partner may also get tested for any STDs to rule to the possibility of getting any such infections.
3. Where Can I Get Emergency Contraception?
Plan B is easily available over the counter at most drugstores and can be purchased without a prescription. Ella is a prescription drug and is only given to you if you have a prescription from your doctor. You can contact a gynaecologist to get an IUD as an experienced doctor or a nurse will have to insert the IUD into your uterus.
4. How Much Does it Cost?
Plan B is available for about $40 to $50. Other ECP pills are available for about $15 to $45. Ella costs around $50 at the drugstore. However, the price may be higher if you order it online. IUD can vary in their cost and the price may go up to about $1000. However, if it is covered by insurance, you may be charged a lower price for the same.
5. Will ECP Have Any Effect on My Next Period?
Most women find that taking an emergency contraception pill affects their menstrual cycle as well as the nature of their period. You may find that your periods occur sooner or later than their usual time. However, most women get their period within the week of their usual date. It is also possible that your blood flow and your cramps may vary. You may have a heavier or lighter period than usual or even have more severe cramps than you normally get.
6. What if I Vomit After Taking the Pill?
In case you vomit within two to three hours after taking the pill, you may have to take another dose of the pill. If you vomit a second time, you generally do not need to repeat the dose. However, it is best that you contact your doctor about taking a second dose after you vomit.
7. Does Using Emergency Contraception Affect Chances of Getting Pregnant in Future?
No. Using emergency contraception will have no effect on your pregnancy chances in the future.
8. Can I Use Emergency Contraception If I’m Nursing?
ECP and IUDs are safe to use even when nursing. However, Ella comes with a caution that breastfeeding moms need to avoid it as the effects haven’t been adequately studied.
9. Can I Get ECP Before I Need Them?
Yes. You can buy over the counter ECP pills any time and keep it for emergencies. You can also reach out to your doctor to prescribe you ECP pills for future use in case the event occurs.
10. How Many Times Can You Use the Morning After Pill?
Although there isn’t a set limit to the number of times you can take the pill, it is best to restrict it under two to three times a month. If you find yourself using it more often, it is best to consult your doctor about an alternate method of regular contraception or birth control pills. The morning after pill should only be taken in emergencies.
While the use of emergency contraceptives has risen significantly over the years, many people have their inhibitions about the effectiveness of the same. It is important to understand that emergency contraception methods work well only in the case of emergency, it should not be made into a regular contraception. Care should be taken to use ECP responsibly and avoid overusing it.
Also Read: A Guide to Intrauterine Device