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Emergency Contraceptive Pills (ECP) - Safety and Indications

Author: Dr. Sujata Mittal - Women's Health  

Safety and Indications:

Nearly half of the pregnancies are unintended, and this is particularly true for teenagers all over the world. Unsafe abortions are a major cause of maternal mortality in some countries, accounting for approximately 8 % of maternal deaths.

As science has progressed, there have been tremendous improvements in contraceptive choices for both women and men. Nevertheless, it is imperative that information spread should be such that clear message is sent to the public in general. As an end user, it is important for the public to understand the utility, safety, and side effects of the drug, as some of the drugs are available over-the-counter like I-pill, Unwanted 72, or Plan B.

What is ECP (Emergency Contraceptive Pills?

As the name suggests, these pills are to be used only in emergency and offer 95 % protection from unwanted pregnancy. Emergency contraception refers to methods of contraception that can be used to prevent pregnancy after sexual intercourse. These are recommended for use within 72 hours, but they are more effective the sooner they are used after the act.

Two methods are recommended by WHO (World Health Organization), one is emergency contraceptive pills, and other is copper-bearing intrauterine devices.

Indications of When to Use Emergency Contraceptive Pills:

  1. When no barrier contraceptive has been used.
  2. Sexual assault.
  3. Condom breakage, slippage, or incorrect use.
  4. Three or more consecutive missed oral contraceptive pills.
  5. Missed Progestin-only birth control pill by more than three hours from the usual time of intake.
  6. Missed Desogestrel pill by more than 12 hours.
  7. Late by four weeks in taking injection Depo-Provera (Medroxyprogesterone acetate).
  8. More than seven days late for combined contraceptive injection.
  9. Tearing or dislodgement of the cervical cap.
  10. Failed withdrawal during ejaculation.
  11. Failure to calculate the safe period days.
  12. Spermicidal jelly or tablet failed to melt before the contact.


  1. Restart birth control pills as soon as possible.
  2. ECP should not be used more than two times a month.
  3. ECP is not a substitute for oral contraceptive pills.
  4. If you vomit immediately after taking the pill, you need to repeat the dose immediately.

Types of ECP (Emergency Contraceptive Pills)

  • ECP Containing Progestin-Only (Levonorgestrel): Plan B and I-pill are one-step pills containing 1.5 mg Levonorgestrel. Next Choice One-Dose and My Way are other names of the same drug.
  • Two Pills Regime: Levonorgestrel 1.5 mg in the form of two pills of 0.75 mg each is available. It can be taken as a single dose of 1.5 mg (both pills may be taken at once) or one pill (0.75 mg) followed by the second pill (0.75 mg) 12 hours later.
  • ECP containing UPA (Ulipristal Acetate).
  • Combined oral contraceptive pills in two doses (Yuzpe method).
  • Copper-bearing intrauterine device.


A pregnancy rate of 1.2 to 2.1 % has been reported with Emergency Contraceptive Pills.

Side Effects of Emergency Contraceptive Pills

  • It can disrupt your cycles and can cause menstrual irregularities, which are normally not severe. There could be spotting and mild to moderate bleeding, depending on how many times you have used it in a cycle. By repeated use, cases of ovarian failure have been reported.
  • Breast tenderness, lower abdominal pain, and cramps are common problems.
  • Headaches can also occur, and those with migraines should consult their doctor before using them.
  • These pills cause nausea, vomiting, dizziness, and fatigue.
  • Decreased appetite with bloating can also be present.

General Facts

  • Patients with liver disease, on antitubercular or antiepileptic drugs, should consult their doctor before use.
  • Some of the HIV drugs like Ritonavir interact with Emergency Contraceptive Pills. Consult your doctor before their use.
  • Emergency contraceptive pills should never be taken on an empty stomach.

So, emergency contraceptives are an essential aspect of contraception, but it should be used with caution.

For more information consult an Obstetrics and Gynaecologist Online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist

Image: Emergency Contraceptive Pills (ECP) - Safety and Indications Last reviewed at: 07.Sep.2018



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