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EMERGENCY CONTRACEPTION
Emergency Contraceptive Pills are ordinary birth control pills containing the hormones estrogen and progestin. Although this therapy is commonly known as the morning-after pill, this term is misleading; ECPs may be used immediately after unprotected intercourse, and up to 72 hours beyond. The treatment schedule is one dose within 72 hours after unprotected intercourse, and a second dose 12 hours after the first dose.
Use of ECPs reduces the risk of pregnancy by about 75%. This does not mean that 25% of women will become pregnant. Rather, if 100 women have unprotected intercourse once during the second or third week of their menstrual cycle, about 8 will become pregnant. If those same women had used emergency contraceptive pills or minipills, only two would have become pregnant (a 75% reduction).
About 50% of women who use ECPs experience nausea and 20% vomit. If vomiting occurs within 2 hours after taking a dose, the dose may need to be repeated. The long-acting non-prescription anti-nausea medicine meclizine (sold as a generic or under the brand names Dramamine II and Bonine) can reduce the risk of nausea when taken an hour before ECPs.
Almost all women can safely use ECPs. Although some women at risk of stroke, heart disease, blood clots, or other cardiovascular problems should not use birth control pills on a regular basis, medical experts believe that a one-time emergency use of birth control pills by active women (women who are not bed-ridden) does not carry the same risks. Among women who definitely need to avoid estrogen, most could use one of the other two emergency contraceptive methods (minipills or the Copper-T IUD).
Emergency Contraceptive Pills require a prescription.
Minipills Used as Emergency Contraception
Minipills are birth control pills that contain only progestin (and not estrogen). They are called minipills not because they are small, but because they contain even less progestin than is found in ordinary oral contraceptives containing both estrogen and progestin. The treatment schedule is one dose within 72 hours after unprotected intercourse, and a second dose 12 hours after the first dose. In the U.S., each dose is twenty (20) Ovrette tablets. In other countries a single pill contains the amount of progestin needed for a single dose. Emergency Minipills are equally as effective as Emergency Contraceptive Pills (ECPs), but nausea and vomiting are far less common. Emergency minipills are an excellent alternative for most women who cannot use ECPs, which contain estrogen.
Emergency minipills require a prescription.
Copper-T IUD as Emergency Contraception
The copper-T intrauterine device (IUD) can be inserted up to 5 days after unprotected intercourse or 5 days after the expected date of ovulation, whichever is later, to prevent pregnancy. Insertion of a copper-T IUD is much more effective than use of ECPs or minipills, reducing the risk of pregnancy following unprotected intercourse by more than 99%. And a copper-T IUD can be left in place to provide continuous effective contraception for up to 10 years. But IUDs are not ideal for all women. Women at risk of sexually transmitted infections (because they or their partners have other sexual partners) may not be good candidates for IUDs because insertion of the IUD can lead to pelvic infection, which can cause infertility if untreated. The risk of pelvic infection from insertion of an IUD is slight among women not at risk of sexually transmitted infections.
Preven
PREVEN emergency contraceptive pills work to prevent pregnancy in similar ways that birth control pills do. PREVEN may:
- stop or delay ovulation (the release of an egg) if this has not already occurred
- stop sperm from fertilizing an egg if it was already released
- stop a fertilized egg from attaching to the wall of the uterus (prevention of implantation).
Used correctly, only about two out of 100 women may become pregnant after an act of sex in a month. When no contraception is used, about 8 out of 100 women may become pregnant.
Studies have shown PREVEN to be a safe and effective form of emergency contraception for most women. In addition PREVEN:
- Can prevent implantation if you take it within 72 hours of unprotected sex
- Won't hurt a pregnancy that has already started — it will not affect a fetus
- Has mild side effects, usually nausea, similar to those of birth control pills; serious risks include heart attack, blood clots and strokes. You should discuss your risk of side effects with your health care provider.
- Is available at many national, regional and independent pharmacies with a prescription from your doctor and at family planning clinics
General Information
- ECPs help prevent pregnancy by preventing an egg from being released, preventing sperm from fertilizing the egg, or preventing a fertilized egg from being implanted.
- ECPs will not work if you are already pregnant.
- ECPs are not 100% effective, but they reduce your chances of getting pregnant.
- ECPs may cause nausea and/or vomiting, sore breasts or headaches. These side effects usually last about one day.
- ECPs do not protect you from sexually transmitted diseases, HIV or AIDS.
Instructions for Use
- Take the first ECP dose within 5 days (120 hours) after unprotected sex.
- Take the second ECO dose 12 hours after the first dose.
- You may be given a medication to prevent nausea or vomiting. Take this medication 30-60 minutes before each ECP dose. This medication may make you feel tired, so be careful if you don't drive or drink alcohol while taking it.
- Do not take extra ECPs. More pills will not make the treatment work better. More pills will increase your risk of feeling sick to your stomach.
- Your next period may be a few days early or late. Do a home pregnancy test or see your health care provider if your period has not started within 3 weeks after taking ECPs. You may be pregnant.
- Talk to your health care provider about regular birth control methods you can use in the future.
Your health care provider can prescribe the following pills to be used for emergency contraception. Use only the type of pill that was prescribed by your doctor.
| Medication Name | # of Pills Per Dose | Color of Pills to Take |
| Alesse | 5 | pink |
| Aviane | 5 | orange |
| Cryselle | 4 | white |
| Enpresse | 4 | orange |
| Lessina | 5 | pink |
| Levlen | 4 | light orange |
| Levlite | 5 | pink |
| Levora | 4 | white |
| Lo-Ovral | 4 | white |
| Low-Ogestrel | 4 | white |
| Nordette | 4 | light orange |
| Ogestrel | 2 | white |
| Ovral | 2 | white |
| Ovrette | 20 | yellow |
| Plan B | 1 | white |
| Portia | 4 | pink |
| Preven | 2 | blue |
| Seasonale | 4 | pink |
| Tri-Levlen | 4 | yellow |
| Triphasil | 4 | yellow |
| Trivora | 4 | pink |
Thomas G. Stovall, M.D.
Dr. Stovall is a Clinical Professor of Obstetrics and Gynecology at the University of Tennessee Health Science Center in Memphis, Tennessee and Partner of Women's Health Specialists, Inc.
Date Published: 2004-03-11
7800 Wolf Trail Cove, Germantown, TN 38138
Phone: (901) 682-9222; Fax: (901) 682-9505