What Is Emergency Contraception?
Emergency contraception is a method to prevent pregnancy when unprotected sexual intercourse has taken place. The emergency contraceptive pills used as a method of emergency contraception are not similar to abortion pills. They do not stop or cause any harm to the fetus if it has already occurred. These emergency contraceptive pills should not be used as a means of regular birth control.
What Is the Mode of Action of Emergency Contraceptive Procedures?
Emergency contraceptive pills work by stopping or preventing ovulation. In some cases, if ovulation has already occurred, they prevent the fertilization of the egg and sperm. However, if fertilization has occurred, they do not stop or harm your conception. In the case of intrauterine devices, they prevent pregnancy by bringing about chemical changes in the egg and sperm before they meet for fertilization.
What Are the Types of Emergency Contraception?
The following are the two methods of emergency contraception available:
Copper IUD (intrauterine device).
1. Hormonal Pills:
Hormonal pills which can be taken for emergency contraception include:
Emergency contraceptive pill with Ulipristal acetate.
Emergency contraceptive pill with Levonorgestrel.
Two doses of oral combined contraceptive pills.
Emergency Contraceptive Pill With Ulipristal Acetate-
These belong to the group of drugs called Progestin receptor modulators. It helps in contraception by preventing ovulation and also thickens the vaginal fluid making it difficult for the sperm to reach the egg. However, it does not provide any form of protection against sexually transmitted infections. One tablet is to be taken at least within five days after sexual intercourse. It is sold under the brand name Ella. It is 60 to 70 percent effective.
Headache, nausea, vomiting, severe menstrual pain, abdominal cramps, fatigue, etc., are the side effects of taking this drug.
Emergency Contraceptive Pill With Levonorgestrel-
Levonorgestrel is a hormone that is used to prevent pregnancy after unprotected sex. It acts by delaying or preventing ovulation. It is sometimes called ‘morning-after pill. It is around 88% effective when taken with 72 hours of sexual intercourse. These are sold under the brand name Plan-B, I-pill, Unwanted-72, etc. A single dose of Levonorgestrel 1.5 mg can be taken, or 0.75 mg Levonorgestrel can be taken initially, and the dose is repeated after 12 hours.
Nausea, fatigue, abdominal pain, changes in the menstrual cycle, vomiting, headache, sore breasts are the side effects of taking Levonorgestrel.
Combined Oral Contraceptive Pills-
Two doses of combined oral contraceptive pills are to be taken, called the Yuzpe regimen. While taking combined oral contraceptive pills for emergency contraception, It has to be taken in two doses, with each dose twelve hours apart. Each dose contains 100 μg of Levonorgestrel and 0.50 mg of Ethinyl Estradiol. It should be taken as early as possible within 72 hours of sexual intercourse or at least before five days. However, combined oral contraceptive devices are proved to be very effective when taken 72 and 120 hours of sexual intercourse.
Side effects of taking this drug are nausea, fatigue, slight vaginal bleeding, and vomiting.
When Should I Take Emergency Hormonal Contraceptive Pills?
In the hormonal pill method, from the above three regimens, one can be chosen. The hormonal pills are to be taken within 72 hours of unprotected intercourse for them to be effective. Once implantation occurs, it will not be effective in terminating the pregnancy.
2. Copper IUD (Intrauterine Device):
A copper-bearing IUD is used most commonly. It can be inserted within five days of unprotected intercourse. It is recommended in women who use a long-acting contraceptive method, reversible and highly effective.
What Is the Mechanism of Action of Copper IUD?
1. It will inhibit or delay ovulation.
2. It affects cervical mucus and so the ability of the sperms to bind to the egg.
How Effective Is Copper IUD?
It is by far the most effective method of contraception available. When inserted within five days, it provides maximum protection of up to 99 %. Also, a woman can continue having it as the method of contraception without removing it or can remove it and move to another form of contraception.
Is It Safe to Have Copper IUD?
In terms of safety, copper IUDs are the safest forms of contraception with minimal and rare side effects compared to other forms of emergency contraception. The incidence of pelvic inflammatory disease, perforation, or expulsion is infrequent.
What Are the Side Effects of Copper IUD?
1. It can affect the next period.
2. Sometimes, there can be heavy bleeding in the subsequent cycle.
When Is Emergency Contraception Needed?
When no form of barrier contraceptive like a condom is used.
When regular combined contraceptive pills were not taken.
After a sexual assault.
Improper or incorrect use of contraceptives or failure of used contraceptives like the following:
Missed combined oral contraceptive pills for three or more days.
Late for more than seven days for the combined injectable contraception.
Late for more than four weeks for the injection of DMPA Progesterone-only.
Late for more than two weeks for the NET-EN Progesterone-only injection.
Delayed by 12 hours for taking 0.75 mg of desogestrel-containing pill, or it has been around 36 hours since the last drug.
Delayed by 3 hours for taking a mini-pill, or it has been 27 hours since you took the pill last time.
Breakage, Incorrect use, or slippage of the condom during sexual intercourse.
Breakage, tearing, dislodgement, or removing the diaphragm or cervical cap.
When the spermicide tablet fails to melt before intercourse.
Failed to withdraw the penis from the vagina during ejaculation.
Miscalculated the safe days and had sex during the fertile days or the days close to ovulation.
Hormonal intrauterine implant or intrauterine device expels out.
Can I Shift to Regular Contraceptive Methods After Emergency Contraception?
After taking the emergency contraception, we can shift to the regular method of contraception. While in the case of using copper IUD, other regular contraceptives are not needed as it acts as a method of contraception and prevents pregnancy. It can also be removed if required.
Although emergency contraception methods are handy in preventing a possible pregnancy, they do not protect you from sexually transmitted diseases (STD). So, it is better to avoid pregnancy and STDs by using the barrier method (condoms) if needed.