HOW AND WHEN ONE TAKES EMERGENCY CONTRACEPTIVE PILL (ECP)

A passionate spontaneous encounter leading to unprotected sex or a traumatic rape can result in an unwanted pregnancy. So what are the other options beside abortion, women in such circumstances can settle for? The answer is very simple. It is the revolutionary emergency contraception, a relatively easy solution.

Emergency contraception is a way to prevent pregnancy after unprotected sex. It does not protect you from AIDS. And it is not the same as abortion because it prevents pregnancy even before it begins. ECPs offer a convenient form of emergency contraception if taken within 72 hours or three days of unprotected intercourse. But remember that it isn’t a substitute for a regular contraceptive. So do not use emergency contraceptives as your only protection against pregnancy if you are sexually active or planning to be, because they are not as effective as any ongoing contraceptive method.

There are two types of emergency contraceptive pills. The first type is a combination ECP that uses the hormones estrogen and progestin similar to the way they are used in some kinds of ordinary birth control pills. The second type are progestin only ESP’s. These are more effective than the first type, and the risk of nausea and vomiting is also lower.

WHEN SHOULD ONE TAKE IT?

An ECP should be used only in emergencies such as when:

You missed two or more birth control pills.

• The condom tore or slipped down.
• Your multiload or copper T has either slipped down or you can’t feel the thread.
• If you have wrongly calculated your safe period while practicing rhythm method of contraception.
• You are a victim of a sexual assault.
• If you’ve had unprotected sex and you weren’t on the pill.

These situations place you at the risk of unwanted pregnancy. Emergency contraceptive pills reduce the risk of pregnancy best when taken within 72 hours after unprotected intercourse. Hence, they are also known as post-coital pills or ‘morning after’ pills. If the pills are taken within this time frame, the risk of pregnancy reduces by 75 per cent to 89 per cent.

HOW DOES THE PILL WORK?

ECP act by either inhibiting ovulation, or by preventing fertilization and implantation.

There are two types of pills available:

1. Progesterone pills ( contains 0.75mg of levonorgestrel ).

2. Combination pills ( contain both estrogen and progesterone ).

The former is preferred by patients because of lesser side-effects.

Depending upon the time of menstrual cycle in which this pill is taken it may act in different ways to prevent a pregnancy.

It may inhibit ovulation if taken in the first half of cycle.

It may inhibit fertilization of the ova by the sperm if taken after ovulation. It may also change the inner lining of the uterus, so that even if taken after fertilization has occurred, it prevents implantation of the embryo.

HOW DO YOU TAKE AN ECP?

It is available as in a pack of two tablets, but you need a doctor’s prescription for it. The first tablet should be taken as soon as possible or within 72 hours of unprotected intercourse. The earlier the first dose is taken the more effective it is. The second tablet should be taken 12 hours after the first one.

You will know that the Ecee 2 pills have taken effect when your period starts. Your periods should come around the time it was expected or they maybe slightly delayed. At times, there may be spotting a few days after taking Ecee 2. If there is a delay of more than a week in the onset of the next menses you should consult your doctor.

There are no side effects of the Ecee 2 pill, but some women do suffer nausea and vomiting. If vomiting occurs within one hour of taking the tablets, contact your doctor as you need to repeat the dose.

If the emergency contraception does not work and you become pregnant, do not panic or worry that you may have damaged the fetus. There is no medical evidence that emergency contraceptive pill would harm a developing fetus or disrupt a pregnancy that has already begun. If you want to continue with the pregnancy you can do so.

WHEN IS IT BEST TAKEN?

ECP should be used after unprotected sex only under the following conditions:

1. The regular contraceptive method has failed.

2. One misses two or more pills of the oral contraceptive pack or starts the new pack late.

3. One has sex without using a contraceptive.

4. After forced intercourse or rape.

HOW OFTEN CAN ONE USE ECP?

One can take ECP as many times as one wants, provided she bears in mind that it is not a substitute for regular contraception. The success of ECP depends on how soon (after intercourse ) one takes the tablet.

1. The highest success rate is when it is taken as soon as possible.

2. Secondly, it depends upon how close to the ovulatory time the woman is. If she is very close to the ovulatory period, the chances of conceiving are more.

WHAT ARE THE SIDE-EFFECTS OF ECP?

Combination pills contain both estrogen and progesterone and have more side-effects, like nausea and vomiting. They can also cause heavy periods.

The progesterone pill contains levonorgestrel and has fewer side-effects. The incidence of side-effects like nausea and vomiting is much lower with this pill.

PROBLEMS ONE FACES WITH ECP?

Frequent use of ECP can cause irregular periods. The next period may be earlier or later than usual. It may be heavy or scanty, or there may be a normal flow. You must contact your gynecologist if you do not get your periods in three weeks or if you have symptoms of pregnancy.

OTHER METHODS OF EMERGENCY CONTRACEPTION

THE INTRAUTERINE CONTRACEPTIVE DEVICE IS AN EFFECTIVE METHOD OF EMERGENCY CONTRACEPTION WHICH IS INSERTED WITHIN 7 DAYS OF UNPROTECTED INTERCOURSE. IT CAN EITHER BE REMOVED AFTER THE NEXT MENSTRUAL PERIOD OR CAN BE LEFT INSIDE AS AN EFFECTIVE MEANS OF CONTRACEPTION. AN ANTI PROGESTOGEN MIFEPRISTONE ( MEDICAL ABORTION PILL) IS ALSO USED.

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