Emergency contraception

Emergency contraception, also known as the morning-after pill or postcoital contraception, is used to reduce the risk of unintended pregnancy after unprotected sex. Emergency contraception is highly effective in preventing pregnancy. It is never used to disrupt or end an established pregnancy.


How it works
Contrary to the term morning-after pill, the most commonly prescribed emergency contraception is actually a series of birth control pills that are most effective when started as soon after unprotected sex as possible. The first dose must be taken within 72 hours of unprotected sex, and a second dose should be taken 12 hours later. How many pills taken with each dose depends on the particular brand of birth control pills. The pills typically contain the hormones estrogen and progesterone. If you can or more of these ways:

delaying or stopping ovulation temporarily
changing the lining of the uterus so the fertilized egg can't implant in the uterine wall
interfering with the transportation of eggs and/or sperm

Indications
Emergency contraception may be appropriate in the following situations:

when the regular contraceptive method fails (when a condom slips or breaks, an intrauterine device is expelled, a diaphragm or cervical cap becomes dislodged,or doses of birth control pills are missed, for example)
after unprotected sex
after a sexual assault
Remember, emergency contraception is not intended to end an established pregnancy.

If you need emergency contraception, contact your doctor or health care facility right away. You may be given a pregnancy test before the pills are prescribed. When you take the medication, follow your doctor's instructions carefully. Remember not to take any extra pills. To help prevent nausea, take the medication with food. Your doctor may also prescribe an anti-nausea pill, usually taken an hour before the emergency contraceptive pills.


Follow-up care
If you begin vomiting within an hour after taking the pills, call your doctor. You may need additional medication. Expect your next menstrual period to begin about two to three weeks after you take the medication. It may be heavier or lighter than usual. If you don't have a period within 21 days, call your doctor. You may need a follow-up appointment to determine the treatment's effectiveness.

Risks
Possible side effects of emergency contraceptive pills include:

nausea and vomiting (for up to 70 percent of women)
breast tenderness
abdominal pain
headache
dizziness
irregular bleeding
fluid retention
rarely, fetal exposure to hormones if pregnancy is not prevented
Possible side effects are similar for progestin minipills, but nausea and vomiting are much less common.


Considerations
Emergency contraception pills are safe for most women. Although there is no conclusive research to indicate these pills will harm a fetus if taken early in a pregnancy, emergency contraception should never be used if you're pregnant.
Emergency contraceptive pills containing estrogen are not recommended for women who have a history of breast cancer, high blood pressure, liver disease or blood clots. Some doctors may choose to prescribe pills containing only progesterone for women at higher risk. Be sure to discuss any concerns you have about your medical history with your doctor before using emergency contraception.

The best approach to birth control is using a reliable method of contraception every time you have sex. Emergency contraception is intended for one-time use. It will not protect you from pregnancy during the rest of your cycle. More importantly, emergency contraception can't protect you from sexually transmitted diseases (STDs). If you're at risk of acquiring an STD, use a condom every time you have sex.

For an alternative to emergency contraceptive pills, ask your doctor about postcoital IUD insertion. With this procedure, the doctor inserts an IUD within five days after ovulation in a cycle when you've had unprotected sex. The procedure is highly effective, but it's not suitable for everyone. Ask your doctor for details.

Prepare for emergency contraception in the future by discussing it with your doctor now.