What is Emergency Contraception: Understanding Your Options

In reproductive health, emergency contraception is a critical and often misunderstood topic. Emergency contraception, often called the “morning-after pill,” is a safe and effective way to prevent pregnancy after unprotected sex or contraceptive failure. This article will delve into emergency contraception, how it works, the types available, and when and how to use it.

Emergency Contraception: The Basics

Emergency contraception (EC) is a birth control method designed for emergencies, such as when a condom breaks, a contraceptive method fails, or no contraception is used during intercourse. It’s important to note that emergency contraception is not meant to be a regular method of contraception but a backup option for unforeseen circumstances.

How Does Emergency Contraception Work?

Emergency contraception primarily prevents pregnancy by delaying or inhibiting ovulation, the release of an egg from the ovaries. It can also make it more difficult for sperm to reach and fertilize the egg or prevent a fertilized egg from implanting in the uterus. It’s crucial to use emergency contraception as soon as possible after unprotected sex because its effectiveness decreases with time.

Types of Emergency Contraception

1. Emergency Contraceptive Pills (ECPs): These are the most common forms of emergency contraception available over the counter in many countries. The two primary types are:
   • Levonorgestrel (Plan B One-Step, Take Action): A single-dose ECP that is most effective when taken within 72 hours (3 days) after unprotected sex but can be taken up to 120 hours (5 days) afterward.
   • Ulipristal acetate (Ella): A prescription-only ECP that can be taken within 120 hours (5 days) after unprotected sex. It’s slightly more effective than levonorgestrel.
2. Copper Intrauterine Device (Cu-IUD): This is a non-hormonal IUD that a healthcare provider can insert into the uterus within five days of unprotected sex. It is the most effective form of emergency contraception and can provide ongoing contraception for up to 10 years.

When Should You Use Emergency Contraception?

Emergency contraception should be used in specific situations, including:

• Contraceptive Failure: When a condom breaks, a diaphragm slips out of place, or any other method of contraception fails.
• Missed Birth Control Pills: If you miss two or more birth control pills in a row or take them irregularly.
• No Contraception Used: When no contraception was used during intercourse.
• Sexual Assault or Coercion: In cases of non-consensual sex, it’s crucial to seek medical care and counseling in addition to emergency contraception.

Effectiveness and Timing

The effectiveness of emergency contraception decreases with time after unprotected sex. It’s most effective when taken as soon as possible:

• Levonorgestrel ECP is most effective within 72 hours (3 days) but can be taken up to 120 hours (5 days) afterward.
• Ulipristal acetate ECP should be taken within 120 hours (5 days) after unprotected sex.
• A copper IUD is effective up to 5 days after unprotected sex and is the most reliable option.

Side Effects and Considerations

Most people tolerate emergency contraception well, but side effects can include nausea, vomiting, breast tenderness, and changes in menstrual bleeding. These side effects are usually mild and short-lived.

Common Side Effects of Emergency Contraception:

1. Nausea: One of emergency contraception’s most common side effects is nausea. Some individuals may experience mild to moderate nausea after taking the medication. This side effect typically subsides within a few hours.
2. Vomiting: In some cases, nausea may lead to vomiting. Contact a healthcare provider or pharmacist if you vomit within two hours of taking an emergency contraceptive pill. They can advise whether another dose is needed.
3. Breast Tenderness: Some people may experience breast tenderness or discomfort as a side effect of emergency contraception. This side effect is generally mild and temporary.
4. Changes in Menstrual Bleeding: Emergency contraception can affect your menstrual cycle. It may lead to changes in the timing of your period or alterations in menstrual flow. Your next period may arrive earlier or later than usual.
5. Fatigue: A feeling of tiredness or fatigue is another potential side effect, although it is less common than nausea.
6. Lower Abdominal Pain: Some individuals may experience mild lower abdominal pain or cramping after taking emergency contraception. This is usually temporary and should be resolved within a short time.

Important Considerations:

1. Effectiveness Decreases with Time: Emergency contraception is most effective when taken as soon as possible after unprotected sex. The energy decreases with time, so it’s essential to act quickly. Levonorgestrel emergency contraceptive pills are most effective when taken within 72 hours (3 days) but can be used up to 120 hours (5 days) after unprotected sex. Ulipristal acetate emergency contraception should be taken within 120 hours (5 days).
2. Ongoing Contraception: Emergency contraception is not a long-term contraceptive method. It’s designed for use in emergencies and should not replace regular contraception. Consider discussing constant contraception options with a healthcare provider.
3. No Protection Against Sexually Transmitted Infections (STIs): Emergency contraception does not protect STIs. If there is a risk of STIs, consider getting tested and using barrier methods such as condoms.
4. Menstrual Changes: Be prepared for potential changes in your menstrual cycle after taking emergency contraception. Your period may come earlier or later than expected.
5. Breastfeeding and Ulipristal Acetate: If you are breastfeeding, it’s important to note that Ulipristal acetate is not recommended. Consult a healthcare provider for guidance on suitable options if you are breastfeeding.
6. Allergic Reactions: Although rare, some individuals may experience allergic reactions to emergency contraception. Seek immediate medical attention if you develop symptoms such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.

To Sum Up

Emergency contraception is a valuable option for preventing unintended pregnancies after unprotected sex or contraceptive failure. However, it’s essential to understand that it should not be used as a primary method of contraception but as a backup option for emergencies. If you need emergency contraception, consult a healthcare provider or a pharmacist who can help you choose the most suitable option based on your circumstances and provide guidance.

References

Cleland, K. et al. (2014) Emergency contraception review: Evidence-based recommendations for clinicians, Clinical obstetrics and gynecology. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216625/ (Accessed: 06 September 2023).

Emergency contraception, World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/emergency-contraception (Accessed: 06 September 2023).

Emergency contraception, ACOG. Available at: https://www.acog.org/womens-health/faqs/emergency-contraception (Accessed: 06 September 2023).