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On Emergency Contraception:
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What is Emergency Contraception (EC)?
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Emergency Contraception is a safe and effective birth control method that can prevent pregnancy after unprotected intercourse or contraceptive failure through the use of hormonal (pill) or non-hormonal (intrauterine device -
IUD). The most common form of emergency contraception is emergency contraceptive pills (ECPs), which contain high dosages of the same hormones found in daily birth control pills - estrogen and progestin or levonogestrel.
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Is EC the Same Thing as the "Morning-After Pill"?
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Some people like to call it the "morning-after pill," although a woman can take her first dose of EC up to 72 hours (about 3 days) after unprotected intercourse or birth control failure (i.e., the condom broke, etc.) and the
second dose 12 hours after the first one. The process of using the emergency contraceptive pill method involves taking two doses of pills, twelve hours apart. It is important that a woman takes the first EC pill as soon as
possible and not later than 72 hours and should remember to take the second dose after 12 hours.
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How do ECPs work (mechanism of action)?
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Emergency contraceptive pills do not cause abortion. The World Health Organization (WHO) studies
and other experts confirm that emergency contraceptive pills can not dislodge or interrupt
pregnancy. ECPs take effect before pregnancy. ECPs inhibit or delay ovulation,
have effect on the ovulation that interferes with the migration of spermatozoids from the
uterine cervix to the tube, and prevents the implantation of a fertilized egg in the uterus.
All the processes take place before pregnancy. Implantation of a fertilized egg (zygote)
takes 5 to 7 days. ECPs are taken within 3 days from sexual intercourse.
It should be noted that even without any intervention of ECPs, not all sexual intercourse
results in fertilization of an egg. However, to ensure that pregnancy is prevented after
unprotected sex and to allay one's anxiety over unwanted pregnancy, women should take the ECPs.
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Can ECPs be considered abortive?
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No, ECPs cannot interrupt or harm pregnancy. ECPs act in the same form as most modern
contraceptives except for the fact that it s administered after and not before sexual
intercourse. It should not be confused with Mifepristone (RU486), popularly known as the
"French pill," that is capable of interrupting a pregnancy. ECPs (combined ethinyl estradiol
and levonogestrel or progestin [levonogestrel] - only pills) prevent pregnancy while
Mifepristone (RU486) can interrupt pregnancy. ECPs take effect before pregnancy, while
Mifepristone take effect after pregnancy started.
The World Health Organization tested levonogestrel in many countries and found out that the
use of levonogestrel alone as an emergency contraceptive is more effective and much better
tolerated by women.
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When should ECPs be used?
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To prevent pregnancy, ECPs should be taken within 72 hours after intercourse
when:
No contraception is used.
A contraceptive method failed (i.e., condom breaks or slips).
Contraceptive pills are missed or incorrectly used.
Coercive sex or rape took place
Emergency contraceptive pills are more effective the sooner they are taken
after unprotect intercourse. It should be taken only in emergency situations
such as stated above and should not be taken as a regular contraceptive
because its effectivity is reduced with repeated or constant use.
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Who can use ECPs?
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Any woman of reproductive age who has had unprotected intercourse and who:
Does not want to become pregnant.
Does not have contraindications.
It is not recommended that women use ECPs as a regular contraceptive method
because studies have shown that repeated and constant use of ECPs decrease
its effectivity. ECPs should only be used in emergency situations. If a
woman is sexually active and does not want to become pregnant, she should
use the regular contraceptive pills and not the ECPs.
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What are the advantages of ECPs?
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It is safe, effective and easy to use.
It can be used any time during the menstrual cycle.
No office visit or physical exam is required.
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What are the disadvantages of ECPs?
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Do not prevent STDs/HIV/AIDS.
Have short-term side effects.
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Are there any side effects associated with ECPs?
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As with most medications and contraceptive pills, there are possible side
effects, depending on each woman. The possible temporary side effects are:
Nausea
Vomiting
Headaches
Dizziness
Fatigue
Spotting or bleeding
Breast tenderness
These side effects are more common in combined pill regimens. Progestin or levonorgestrel-only pills have less side effects. The temporary side effects generally do not last more than 24 hours.
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What kinds of emergency contraceptive pills are available?
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In the United States, there are two "dedicated" emergency contraceptive pills currently
approved by the Food and Drug Administration (FDA). One is Preven, a combination of estrogen
and progestin, and the other one is Plan B, which contains Progestin (levonogestrel) only.
In Asia, there are several brand names, such as Yu Ting and Hui Ting, Madonna, and Postinor.
In Southeast Asia, ECPs are available in Burma, Malaysia, Singapore and
Thailand. It is in the process of registration in Indonesia. In the Philippines,
Postinor was registered in April 2000, but was subsequently delisted by the Bureau of Food
and Drugs (BFAD) in December 2001 before women even knew of its existence. The delisting of
Postinor (levonogestrel) in the Philippines is believed to have been instigated by
religious groups who are against contraception and who are actively disseminating
misinformation by falsely claiming ECPs to be an "abortifacient" in spite of the fact that
the World Health Organization and experts have already endorsed it as a safe contraceptive
and that it can not interrupt or harm pregnancy. Regular contraceptive pills can also act
as emergency contraceptives if taken in higher doses, depending on the progestin content
of the different pills. This requires a doctor's assistance to determine the correct dose.
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How can women get ECPs?
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In some countries where ECPs are available, a doctor's prescription is required. However, in some States in the United States such as in California and Washington, ECPs are available over the counter (without need of
doctor's prescription).
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