Emergency contraception

Definition

Emergency contraception is a method of birth control that can be used within 3 days of sexual intercourse.

Alternative Names

Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B; Preven

Information

Emergency contraception is a method to prevent pregnancy in women who have had unprotected sex. It can be used following many different situations including rape, unplanned acts of intercourse, or when a birth control method fails. For example, if a condom breaks, a diaphragm slips out of place, or a woman forgets to take birth control pills.

Emergency contraception drugs are not the same as the "abortion pill." A woman who knows she is pregnant takes the abortion pill with the intent to end an early pregnancy (usually 4 to 7 weeks after conception). Emergency contraception pills are taken after unprotected sex to prevent pregnancy from occurring.

Unlike most types of birth control, which must be put in place or taken before intercourse, emergency contraception can be used up to 3 days after intercourse.

TYPE OF EMERGENCY CONTRACEPTION

Several types of emergency contraception drugs are available.

Birth control pills can be used for emergency contraception. You must take two to five "regular" pills together to equal one dose of emergency contraception.

Two drugs are specifically FDA-approved for emergency contraception. They are similar to birth control pills, but contain higher levels of hormones. Plan B contains levonorgestrel and Preven contains levonorgestrel and ethinyl estradiol.

The first dose of emergency contraception pills can be taken up to 72 hours after unprotected intercourse. The second dose is taken 12 hours after the first. These drugs work the best when taken as soon as possible after intercourse.

Emergency contraceptive drugs work by preventing or delaying the release of an egg (ovulation). They may also slow egg or sperm movement in the fallopian tubes and may make it harder for an embryo to stick to the lining of the uterus.

An intrauterine device (IUD) may help prevent against contraception if put into place within 5 days after unprotected intercourse. An IUD is a birth control device that is inserted into a woman's uterus by a health care provider. However, IUDs are intended to provide long-term birth control for 1-10 years.

Emergency contraception is available over-the-counter for women age 18 and older.

Emergency contraception pills prevent about 75 - 89% of pregnancies that occur after unprotected sexual intercourse. Emergency contraception by IUD insertion is even more effective.

SIDE EFFECTS

Mild and often unpleasant side effects from emergency contraception medications may include nausea, vomiting, abdominal pain, fatigue, headache, and changes in menstrual bleeding. Nausea and vomiting are the most common. Nausea occurs about 50% of the time and vomiting about 20% of the time after emergency contraceptive pills are taken.

Some doctors recommend taking an anti-emetic medication (a drug to prevent nausea and vomiting) before taking the emergency contraception pills to prevent such side effects. Progesterone-only emergency contraceptives cause less nausea and vomiting than pills that contain both progesterone and estrogen-like medications.

After taking emergency contraception, a woman's next menstrual cycle may start earlier or later than expected and the menstrual flow may be lighter or heavier than usual. Most women will start their next period within 7 days of the expected date. If a woman's menstrual bleeding does not start within 3 weeks after taking emergency contraception, she might be pregnant and should call or visit her health care provider.

IUD placement has risks of pelvic infection and uterine injury, although these are quite rare. Long-term use of an IUD for birth control may cause side effects, such as heavy menstrual bleeding and painful menstrual cramps.

SPECIAL CONSIDERATIONS

Women who believe that they are already pregnant and may have been for longer than several days should not take emergency contraception medications, since their effects have not been well studied. Also, women who have vaginal bleeding for an unknown reason should discuss this with their health care provider before taking emergency contraception.

Women who cannot take birth control pills regularly in most cases may still be able to use emergency contraceptives, but they should also discuss this option with their health care provider.

If emergency contraception fails and the woman becomes pregnant, there do not appear to be any long-term effects on the pregnancy or the fetus.

Emergency contraception should not be used as a routine birth control method, because it is actually less effective at preventing pregnancies than most types of birth control.