World contraception day 26th September 2016 talking about emergency contraception
By Dr Brighton Chireka
Today is the world contraception day and I am taking this opportunity to raise awareness about emergency contraception which is popularly known as the morning after pill. Emergency contraception is just for the morning after the night before when something did not quite go to plan. Accidents do happen in all walks of life and sex is no different. Emergency contraception does offer a second chance to prevent pregnancy after having unprotected sex or if your contraceptive method has failed – for example, a condom has split or you’ve missed a pill.
What is emergency contraception?
These are pills used to stop,or delay the ovaries from releasing an egg or devices that work by changing the lining of the womb that may prevent implantation of a fertilised egg. Time is of the essence here so for best chance for it to work , it should be taken as soon as possible after unprotected sex .
Emergency contraception is not intended for regular use and does not protect against Sexual transmitted infections or HIV. After using emergency contraception one should use another form of contraception for the rest of the cycle to protect themselves if they do not want to become pregnant. However if you use the IUD as emergency contraception, it can be left in as your regular contraceptive method.
Types of emergency contraception
There are two types , one is the emergency contraceptive pill popularly knows as the morning after pill. The other type is the Intrauterine device (IUD) or coil. With the pill there are two kinds of emergency contraceptive pill- the Levonelle and ellaOne. Levonelle has to be taken within 72 hours (three days) of sex, and ellaOne has to be taken within 120 hours (five days) of sex. Both pills work by preventing or delaying ovulation (release of an egg).
The IUD can be inserted into the uterus up to five days after unprotected sex, or up to five days after the earliest time one could have ovulated. It may stop an egg from being fertilised or implanting in the womb.
Points to remember about emergency contraceptive pill
- The pill can make you feel sick, dizzy or tired, or give you a headache, tender breasts or abdominal pain but this mild and does not last long.
- The sooner you take the pill , the more effective it will be.
- The pill can make one have their period earlier or later than usual. See your doctor if your period is more than seven days late as you may be pregnant.
- If you’re sick (vomit) within two hours of taking Levonelle, or three hours of taking ellaOne, seek medical advice as you will need to take another dose or have an IUD fitted.
- If you use the IUD as a regular method of contraception, it can make your periods longer, heavier or more painful.
- You may feel some discomfort when the IUD is put in – painkillers can help to relieve this.
- There are no serious side effects of using emergency contraception.
- Emergency contraception does not cause an abortion.
- Levonelle and ellaOne do not continue to protect you against pregnancy. This means that if you have unprotected sex at any time after taking the emergency pill you can become pregnant.
- Levonelle is fairly safe whereas so can taken by anyone whereas ellaOne is not recommended in those with asthma and for those breastfeed they have to stop for seven days after taking it. ellaOne does also react with other drugs as shown below.
What to do after taking the emergency contraception
Depending on the reason for taking the morning after pill , you may want to start or resume a regular form of contraception. If you have taken Levonelle, then you should:
take your next contraceptive pill, apply a new patch or insert a new ring within 12 hours of taking the emergency pill ( for ellaOne wait for 5 days before your next contraceptive pill). You should then continue taking your regular contraceptive pill as normal but you need additional contraception, such as condoms, for:
the next seven days if you use the patch, ring, combined pill (except Qlaira which needs 9 days), implant or injection. As for the progestogen-only pill you need just two days.
Please contact your doctor after taking the emergency pill if ;
you think you might be pregnant
your next period is more than seven days late
your period is shorter or lighter than usual
you have any sudden or unusual pain in your lower abdomen (this could be a sign of an ectopic pregnancy, where a fertilised egg implants outside the womb – this is rare but serious, and needs immediate medical attention)
The emergency pill and other medicines
The emergency contraceptive pill may interact with other medicines. ellaOne cannot be used if you are taking the following medicines , as it may not be effective. Levonelle may still be used with the following medicines , but the dose may need to be increased. Speak to your doctor or pharmacist for further advice.
These medicines include:
the herbal medicine St John’s Wort
some medicines used to treat epilepsy
some medicines used to treat HIV
some medicines used to treat Tuberculosis (TB)
medication such as omeprazole (an antacid) to make your stomach less acidic
There should be no interaction between the emergency pill and most antibiotics but if you are taking rifampicin or rifabutin you must not use ellaOne
Where can I get emergency contraception?
You can get the pill from a pharmacist without a prescription or you can get it from your doctor. Family planning clinics , sexual health clinics and genitourinary medicine clinics will all be able to supply patients with emergency contraceptive pills.
Having written about emergency contraception it would not be right if I do not put emphasis on the need for a regular method of contraception. If you are not using one , you might consider doing so in order to lower the risk of unintended pregnancy. Long-acting reversible contraception (LARC) offers the most reliable protection against pregnancy, and you don’t have to think about it every day or each time you have sex. I will cover LARC in one of my articles in the near future.
We must also not forget to have safe sex and prevent against Sexual Transmitted Infections. I would like to hear from you about your experiences in trying to get emergency contraception.
This article was compiled by Dr Brighton Chireka , who is a GP and a blogger based in Kent in the United Kingdom. Feel free to contact him at firstname.lastname@example.org and you can read more of his work on his blog at DR CHIREKA’S BLOG
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Dr Chireka has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other healthcare professionals for a diagnosis and treatment of medical conditions. Views expressed here are personal and do not in any way , shape or form represent the views of organisations that Dr Chireka work for or is associated with.