Emergency Contraception – A Bridge Toward Regular Contraception
September 15, 2020
There is a lot to consider about modern-day emergency contraception: what to use and when to use it, how it could affect you and much more. This comprehensive article shares everything you need to know about emergency contraception and its unique role as a BRIDGE to regular contraception.
Summary By Author: This article is subdivided into two sections. The first section describes basic knowledge about emergency contraception: methods, types, how they work and are used, their effectiveness in preventing unintended pregnancy, associated risks, benefits, and side effects and dispels some myths around their use. In the second section, we look at establishing linkages between emergency and regular contraception.
What is Emergency Contraception (EC)?
Emergency Contraception (EC) for women refers to any device or drug used as an emergency procedure to prevent pregnancy after unprotected sexual intercourse (including sexual assault) or after a recognized contraceptive failure.
It is commonly known as:
What are the types of Emergency Contraception (EC), and How Are They used? (Usage Method)
Emergency Contraception is widely available as hormones (estrogen, progesterone or ulipristal acetate) oral pills form.
Time is of the essence to prevent unintended pregnancy.
You are advised to take the pill(s) at your earliest convenience after unprotected sexual intercourse.
For some forms, this will be up to 72 hours; for others, it is up to 5 days.
Table 1 highlights different preparations (forms) and the use of Emergency Contraception Pills (ECPs).
Intra Uterine Devices (IUDs) as Emergency Contraception
How Do ECPs Work? (Mode of Action of ECPs)
How effective is Your ECP?
What is the effect of ECPs on Women’s fertility?
Are there any Conditions where you Cannot Use ECPs? (Risks factors for using ECPs in different health conditions).
The World Health Organisation (WHO) has described different medical conditions in which women can safely use ECPs[v].
Please refer to Table 2 below:
· Can use LNG or COCs regimen
· Can use UPA regimen, but breastfeeding is not recommended for one week after taking UPA since it is excreted in breast milk. Breast milk should be expressed and discarded during that time.
|Past Ectopic Pregnancies||YES||Can use COCs, LNGs or UPA regimen|
|Severe Cardiovascular Disease, including Ischaemic Heart Disease, Cerebrovascular Attack (Stroke), or other Thromboembolic conditions (such as DVT or Pulmonary Embolus).||YES||Can use COCs, LNGs or UPA regimen|
|Migraine||YES||Can use COCs, LNGs or UPA regimen|
|Obesity||YES||Can use COCs, LNGs or UPA regimen|
|Currently on drugs known as CYP3A4 inducers (e.g. Rifampicin, Phenytoin, Phenobarbital, Carbamazepine, Efavirenz, Fosphenytoin, Nevirapine, Oxcarbazepine, Primidone, Rifabutin, St John’s wort/Hypericum perforatum)|
|Can use COCs, LNGs or UPA regimen|
What are the factors that facilitate the long-term use of Contraception?
Various sources of evidence suggest that women’s voluntary and long-term use of a specific contraceptive method depends on the degree of comprehensive information, education and counselling they have about it.
Benefits, Side Effects & Myths of Emergency Contraception.
It is important that you know not only the benefits but possible side effects of your emergency contraception.
Some of these are highlighted in Figure 1.
Figure 2 below addresses common myths you may know about using emergency contraception.
Control leads to compliance; autonomy leads to engagement.Author Daniel H. Pink
|Hormone||Popular Brand Name|
|Ulipristal Acetate||Ella, EllaOne, Esmya, Fibristal|
|Levonorgesterel||Alesse, Altavera, Alysena, Amethia, Amethyst, Ashlyna, Aviane, Camrese, Chateal, Climara Pro, Cycle 21, Daysee, Emerres, Enpresse, Erlibelle, Escapelle, Falmina, Introvale, Isteranda, Jadelle, Jaydess, Jolessa, Klimonorm, Kurvelo, Kyleena, Lessina, Levlen, Levodonna, Levonelle, Levonest, Levosert, Levora, Liletta, Loette, Logynon, LoSeasonique, Lutera, Lybrel, Marlissa, Microgynon, Microlut, Microvlar, Min-Ovral, Miranova, Mirena, My Way, Myzilra, Next Choice, Nordette, Norgeston, NorLevo, Norplant, One Pill, Option 2, Orsythia, Ovima, Ovranette, Plan B, Plan B One-Step, Portia, Postinor, Postinor-2, Post Pill, Preventeza, Ramonna, Rigevidon, Quartette, Quasense, Seasonale, Seasonique, Skyla, Sronyx, Tri-Levlen, Trinordiol, Triphasil, Triquilar, Tri-Regol, Trivora, and Upostelle.|
|IUD||Copper Coil, Copper IUD (Variety of brands per country; check with your provider.)|
[vi] . “Can We Identify Women at Risk of Pregnancy despite Using Emergency Contraception? Data from Randomized Trials of Ulipristal Acetate and Levonorgestrel.” Contraception. U.S. National Library of Medicine, October 2011.
About the author: Dr Sanchika Gupta is a healthcare specialist with 7+ years of experience, both as a clinician and public health professional in national and international NGOs. Her fieldwork in different geographies across India spans a wide breadth of the public health realm viz. family planning, sexual and reproductive health and rights, adolescent health, maternal and child health. Declaration: This is the original written work of Dr. Sanchika Gupta. Should you need any further information, please do not hesitate to contact her at the email-id: email@example.com or tweet @sanchika_gupta.
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