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 for 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 does not stop or harm one’s 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:
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Hormonal pills.
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Copper IUD (intrauterine device).
1. Hormonal Pills:
Hormonal pills that can be taken for emergency contraception include:
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Emergency contraceptive pill with Ulipristal acetate.
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Emergency contraceptive pill with Levonorgestrel.
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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 thickening 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 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, and others 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 percent effective when taken within 72 hours of sexual intercourse. A single dose of Levonorgestrel 1.5 mg can be taken, or 0.75 mg (milligram) Levonorgestrel can be taken initially, and the dose is repeated after 12 hours.
Nausea, fatigue, abdominal pain, changes in the menstrual cycle, vomiting, headache, and 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 (microgram) 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 five days. However, combined oral contraceptive devices are proven to be very effective when taken between 72 and 120 hours of sexual intercourse.
Side effects of taking this drug are nausea, fatigue, slight vaginal bleeding, and vomiting.
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, which is reversible and highly effective. The side effects of a copper IUD include the potential to affect the next period and sometimes heavy bleeding in the subsequent cycle.
Certain EC pills are available for purchase without a prescription, while others require one. Inserting the IUD must be done by a healthcare professional like an obstetrician-gynecologist or another qualified individual.
When Should an Individual 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.
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 sperm to bind to the egg.
What Is the Effectiveness and Safety of the 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 percent. Also, a woman can continue to use it as a method of contraception without removing it or can remove it and move on to another form of contraception.
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.
When Is Emergency Contraception Needed?
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When no form of barrier contraceptive like a condom is used.
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When regular combined contraceptive pills were not taken.
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After a sexual assault.
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Improper or incorrect use of contraceptives or failure to use contraceptives like the following:
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Missed combined oral contraceptive pills for three or more days.
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Late for more than seven days for the combined injectable contraception.
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Late for more than four weeks for the injection of DMPA (depot medroxyprogesterone acetate) progesterone-only.
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Late for more than two weeks for the NET-EN (norethisterone enanthate) progesterone-only injection.
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Delayed by 12 hours for taking 0.75 mg of Desogestrel-containing pill, or it has been around 36 hours since the last drug.
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Delayed by three hours for taking a mini-pill, or it has been 27 hours since one took the pill last time.
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Breakage, incorrect use, or slippage of the condom during sexual intercourse.
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Breakage, tearing, dislodgement, or removing the diaphragm or cervical cap.
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When the spermicide tablet fails to melt before intercourse.
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Failed to withdraw the penis from the vagina during ejaculation.
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Miscalculated the safe days and had sex during the fertile days or the days close to ovulation.
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Hormonal intrauterine implant or intrauterine device expels out.
Can One Shift to Regular Contraceptive Methods After Emergency Contraception?
After taking the emergency contraception, one can shift to the regular method of contraception. In the case of using a 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.
How to Start or Resume Using a Birth Control Method After Taking Emergency Contraception Pills?
To restart or begin using birth control after taking emergency contraception pills, it depends on the type one took:
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If someone uses the progestin-only pill or combined EC pills, they can begin or continue any birth control method right away. For the next seven days, they should also use a barrier method like condoms, diaphragms, or spermicides along with their regular birth control or avoid having sex.
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Suppose someone has taken Ulipristal and wishes to begin or resume using a hormonal birth control method such as the patch, implant, ring, pill, shot, or hormonal IUD. In that case, they should wait for five days after taking Ulipristal. During this time and until their next period, they should also use a barrier method or avoid having sex. Using a hormonal birth control method and Ulipristal at the same time can make both less effective.
Conclusion:
Although emergency contraception methods are handy in preventing a possible pregnancy, they do not protect against sexually transmitted diseases (STDs). So, it is better to avoid pregnancy and STDs by using the barrier method (condoms) if needed. Emergency contraception pills can be taken multiple times in one menstrual cycle, but they should not be the main way of preventing pregnancy long-term. They are not as good at preventing pregnancy as using a regular birth control method correctly every time. Taking emergency contraception often might also cause more side effects compared to using a regular birth control method.
