Emergency contraceptives are used to prevent pregnancy after unprotected sexual intercourse. It is usually recommended within 3 days (72 hours)of exposure to sexual intercourse. It is however more effective if you use it much earlier.
Indications for emergency contraceptive use
According to WHO, the indication for emergency contraceptive includes;
- Unprotected sex
- Sexual assault
- Incorrect use of contraceptives such as;
- Condom slippage or breakage
- 3 or more consecutively missed combined oral contraceptive pills;
- More than 3 hours late from the usual time of intake of the progestogen-only pill (minipill), or more than 27 hours after the previous pill;
- More than 12 hours late from the usual time of intake of the desogestrel-containing pill (0.75 mg) or more than 36 hours after the previous pill;
- More than 2 weeks late for the norethisterone enanthate (NET-EN) progestogen-only injection;
- More than 4 weeks late for the depot-medroxyprogesterone acetate (DMPA) progestogen-only injection;
- More than 7 days late for the combined injectable contraceptive (CIC);
- Dislodgment, breakage, tearing, or early removal of a diaphragm or cervical cap;
- Failed withdrawal (e.g. ejaculation in the vagina or on external genitalia);
- Failure of a spermicidal tablet or film to melt before intercourse;
- Miscalculation of the abstinence period, or failure to abstain or use a barrier method on the fertile days of the cycle when using fertility awareness based methods; or
- Expulsion of an intrauterine contraceptive device (IUD) or hormonal contraceptive implant.
Emergency contraceptive helps to prevent pregnancy by delaying the release of egg from the ovary or preventing implantation of the fertilized ova in the uterus. emergency contraceptive can also prevent the way sperms move in the body. It doesn’t harm developing embryo
Types of emergency contraceptive
- Emergency contraceptive pill; These are also known as ‘morning after pill’ which are medications used to disrupt or delay ovulation or fertilization. They contain higher doses of estrogen, progesterone or both compare to normal contraceptive pills. The failure rate of emergency contraceptive pill is higher in women who are obese (BMI>30kg/m2). Examples of emergency contraceptive pill readily available over the counter includes;
- Levonorgestrel-only pills; taken at 0.75mg 12hours apart.
- Emergency combined oral contraceptives; this is to be taken 12hours apart and each tablet contains 100mcg of estrogen and 0.50 mg of progesterone.
- Copper intra uterine contraceptive device; this is the insertion of a small T shaped copper labelled device into the uterus of the woman. It is inserted by a trained nurse or a doctor. It is the preferred method in overweight/ obese women. It also promoted long term contraception according to WHO it is the most effective form of emergency contraceptive available
Most side effects of emergency contraceptives are mild and they include; vomiting, nausea and feeling sick. There is a small risk of ectopic pregnancy (implantation of the fertilized egg) in those that use emergency contraceptives. Copper bearing IUD can lead to an increased risk of pelvic inflammatory disease. Contraceptive failure can occur in a very small percentage of people. Therefore, it is important you go for a pregnancy test 4 weeks after the use of emergency contraception.
It is important to note that the usage of emergency contraceptive pills very frequently increases its failure rate and can lead to menstrual irregularities. It is therefore important you practice abstinence or safe sex. Make use of a regular family planning method to avoid unwanted pregnancy.