EMERGENCY CONTRACEPTION METHODS – TYPES, ADVANTAGE AND DISADVANTAGE

Emergency contraception (EC), or emergency postcoital contraception, refers to contraceptive measures that, if taken after sex, may prevent pregnancy. Emergency contraceptive methods can prevent pregnancy after unprotected intercourse, method failure or incorrect method use. Unprotected intercourse may include coerced sex, as well as situations when no method is used. Emergency contraception is a “second chance” method.

Women may wish to consider emergency contraception if she –

1. Made love unexpectedly
2. Were forced to have unprotected vaginal sex
   
3. Had a condom break, slip or come off
   
4. Forgot to take several birth control pills
   
5. Weren’t using any form of birth control
   
6. Expected your partner to pull out… but he didn’t?
   
7. Unintentionally let “outercourse” lead to intercourse without proper protection?
   

 

1. Emergency Contraceptive Pills

After unprotected sex, emergency oral contraception or morning after pill can prevent pregnancy. It is also called morning –after or post-coital contraception. Oral contraceptive pills may contain higher doses of both estrogen and progestin or those that only contain a progestin can be used for emergency contraception. Mifepristone can be used as EC, but is an anti-hormonal drug, and does not contain estrogen or progestins. Emergency contraceptive pills do not affect a fertilized egg that has been implanted in the uterus. Hence, it cannot cause an abortion.

ECPs are effective when used shortly before intercourse, and are licensed for use up to 72 hours after sexual intercourse and the WHO says they can be used for up to 5 days after contraceptive failure.

Emergency Contraceptive Pills are taken in two doses. Take the first dose as soon as possible after unprotected intercourse and the second dose 12 hours later. Or alternatively, both pills can be taken together. This option does not change the effectiveness, but may be more convenient.

 

TYPES OF EMERGENCY CONTRACEPTIVE PILLS

1. The combined or Yuzpe regimen uses large doses of both estrogen and progestin, taken as two doses at a 12-hour interval. This method is now believed to be less effective and less well-tolerated than the progestin-only method. This technique is believed to be approximately 75% effective depending on how soon it is taken after unprotected intercourse.
2. The progestin-only method uses the progestin levonorgestrel in a dose of 1.5 mg, either as two 750 mg doses 12 hours apart, or more recently as a single dose. This method is now known to be more effective (up to 89 percent) and better tolerated (less nausea or vomiting) than the Yupze method.
   
3. The drug mifepristone (RU486, Mifeprex) may be used either as an ECP or as an abortifacient, depending on whether it is used before or after implantation. As EC, a low dose of mifepristone is slightly less effective than higher doses, but has fewer side effects. For 10 mg of mifepristone taken up to 120 hours (5 days) after intercourse, the combined estimate from three trials was an effectiveness of 83%.
   

Risks and Side Effects: emergency contraceptive pills can cause nausea, vomiting, headache, weight gain, fatigue, abdominal pain and cramp; vaginal ‘spotting’ of blood and dizziness, breast tenderness and can disrupt the regularity of the menstrual cycle. Serious side effects such as blood clots, heart attack and stroke are extremely rare.

 

ADVANTAGES OF EMERGENCY CONTRACEPTIVE PILLS

 

1. ECPs prevent unwanted pregnancies after forced intercourse, a mistake, or a condom breakage.
2. Emergency contraception pills do not affect future fertility
   
3. ECPs can help to prevent abortions and are less costly
   
4. They can be obtained and left in medicine cabinet in case of an emergency such as condom breakage or forced sex
   

 

DISADVANTAGES OF EMERGENCY CONTRACEPTIVE PILLS

1. ECPs can cause nausea, vomiting, breast tenderness, headaches, dizziness, and irregular bleeding
2. ECPs are not as effective as other contraceptives. Also, ECPs are not as effective as inserting a Copper T IUD after unprotected sex
   
3. ECPs should only be used in the case of an emergency and should not be used as regular contraceptive.
   
4. ECPs provide no protection against sexually transmitted infections; you may need to be treated for infection
   

 

2. Intrauterine Devices

Intrauterine devices (IUDs) are usually used as a primary contraception method, but sometimes used as emergency contraception. An IUD is a small, flexible T-shaped object that is placed in the uterus to protect against pregnancy. An alternative to emergency contraceptive pills is the Copper-T intrauterine device. A clinician can insert Copper T380-IUD for emergency contraception within five days of unprotected intercourse to prevent pregnancy. There are two main types of intrauterine contraceptives: those that contain copper (which has a spermicidal effect), and those that release a progestin (a synthetic progestogen). Emergency IUD insertion reduces the risk of pregnancy by 99.9 percent. IUDs may be left in place following the subsequent menstruation to provide ongoing contraception (3-10 years depending upon type).

Risks and side effects: Side effects are similar to those for regular IUDs. Patients may experience cramping, heavier, longer and irregular menstrual bleeding.

 

ADVANTAGES OF AN IUD

1. Extremely effective in protecting against pregnancy
   
2. One of the least expensive methods of birth control on the market
   
3. Does not interrupt lovemaking
   
4. Women who cannot take hormones can use the Copper T
   

 

DISADVANTAGES OF AN IUD

1. Increased risk of infection in the first 4 months
2. Can be expelled (pushed out) without the woman knowing it.
   
3. The Copper T can increase menstrual blood loss and increase menstrual cramps
   
4. It is very rare, but possible, that the IUD punctures the uterus.
   

EMERGENCY CONTRACEPTION METHODS – TYPES, ADVANTAGE AND DISADVANTAGE