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DESCRIPTION
The goal of contraception (or birth control) is to prevent an unplanned pregnancy. The majority of methods of contraception enable sexually active couples to temporarily avoid pregnancy. Permanent birth control is accomplished through sterilization. Be sure you know and understand the different types of birth control available to you, the risks and benefits of each, and any side effects, so that you can make an informed choice.
MoonDragon's Contraception Methods Compared
The morning-after pill (or post-coital pill) is considered emergency contraceptive pill (ECP) and consists of a series of very high doses of estrogens (generally diethylstilbestrol [DES]), progesterones or combination pills. Different brands of combination oral contraceptive pills can be used as emergency contraception: however, the ones used most contain a specific type and amount of estrogen and progestin. They may be effective in preventing pregnancy if initiated within 72 hours of sexual intercourse.
The way in which ECPs work has not been clearly established, although the mechanism of action probably depends upon the time of the menstrual cycle in which they are taken. This method of birth control works by altering the ability of a fertilized egg to implant and grow, thus preventing a pregnancy. They do not interrupt or disrupt an already-established pregnancy. Some research suggests that they may stop the process of ovulation, so the egg doesn't leave the ovary at all, or it may leave later than usual. It may affect how the egg and sperm travel through the fallopian tube, so that fertilization is not able to take place. They may also work by disturbing the way the lining of the uterus develops. This means that if the egg is fertilized, it doesn't have a healthy environment in which to grow. It is usually not recommended as a routine birth control method, rather it is reserved for special circumstances.
The drug mifepristone (also known as RU-486) used in Europe is also effective and may be approved for use in the U.S.
ADVANTAGES
ECPs are easy to use. Side effects, if any, will only last a short time.
Safer than surgical pregnancy termination.
Is generally effective for birth control (97-99%), but effectiveness varies depending on the time of the woman's menstrual cycle; if taken at mid-cycle, the failure rate is higher.
It is an immediate form of birth control should unexpected intercourse occur, such as with rape victims.
It is a backup birth control option for couples experiencing failure of other methods: expulsion of an intrauterine device (IUD), condom breakage or diaphragm displacement.
DISADVANTAGES
Not 100% effective for birth control.
Must be prescribed by a health care provider.
Side effects occur including nausea, vomiting, headache, breast tenderness, bloated feeling and swelling of hands and feet. The side effects may be less with the combination pill and more severe with the use of the high-dose estrogen alone.
If pregnancy does occur, the use of these drugs can have significant effects on the developing embryo. Pregnancy terminations may have to be considered.
The long-term effects of even one-time use of diethylstilbestrol have not been studied.
Does not prevent sexually transmitted diseases (STDs) from being transmitted in unprotected sexual encounters.
GENERAL MEASURES
INSTRUCTIONS FOR USE
You should be examined by a heath care provider before taking a morning-after pill.
The pills may be taken beginning within 24 hours and not later than 72 hours after unprotected intercourse. Generally, the high-dose estrogen, is taken once daily for 5 days; the combination pill (oral contraceptive) consists of taking 2 tablets followed by 2 more tablets in 12 hours. The sooner they are taken after unprotected intercourse, the more effective they are in preventing pregnancy.
Take the ECPs prescribed by a health care provider. The health care provider will decide the kind of pills and the proper doses that are best for you. Do not take extra pills on your own AND do not take a friend's birth control pills. Because some women become nauseous when they take a few pills at the same time, the health care provider may give medication to prevent this. Be sure to take this medication as instructed.
A follow-up examination in 3 to 4 weeks is recommended to assess the effectiveness of the treatment, especially if you don't have a normal menstrual period at this time after taking ECPs. You may need to be tested for a possible pregnancy. Another form of birth control, if needed, should be discussed.
SIDE EFFECTS
Nausea and vomiting: Usually does not occur when progestin-only ECPs are taken. The nausea may last for a day and it is usually mild. Eating a snack or drinking a glass of milk can reduce nausea. Contact your clinician if you vomit within an hour after taking a dose. You may have to repeat a dose.
- Headaches
- These may be either mild or painful
- Breast tenderness
- Fluid retention
- Fatigue
- Dizziness
All of these side-effects are temporary and will usually go away within a day after the pills are taken.
COMPLICATIONS & PRECAUTIONS
There do not seem to be any complications associated with the use of ECPs. The amount of hormones taken is very small and therefore, the chances of ECPs causing abnormal blood clotting, stroke, heart attack, or any other health problem is very unlikely.At this time, emergency use of combined oral contraceptives is considered safe even if a woman has contraindications to long-term use of estrogen, such as a history of blood clots. The only absolute reason ECPs should not be used is if a pregnancy has been confirmed. However, should a woman be pregnant yet not know this, ECPs will not be harmful to the pregnancy.
EFFECTIVENESS
If a woman has unprotected intercourse one time during the fertile days of her menstrual cycle, her chances of becoming pregnant are 8 percent. If she takes ECPs according to instructions, her chances are reduced to 2 percent. This means ECPs reduce the chances of pregnancy by 75 percent.
Research has not yet been conducted to determine the pregnancy rate if ECPs are taken incorrectly.
Ideally, the first dose of pills should be taken within 12 hours of unprotected intercourse to be most effective. However, they can be taken up to 72 hours after unprotected intercourse and still work to prevent pregnancy.
If a woman vomits within one hour of the first dose, she probably has received enough of the hormones to prevent pregnancy. However, because this may not be true for everyone, it is probably a good idea for the woman to repeat the dose or call the clinician and take a medication to prevent vomiting.
MEDICATION
Don't take any other medications during the time of treatment with the morning-after pill without medical approval.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You have had unprotected intercourse and want information about birth control options available to you.
Following treatment with the morning-after pill, you experience unexpected side effects.
You suspect you are pregnant after undergoing treatment.
EMERGENCY-MORNING AFTER CONTRACEPTION
Emergency Contraceptives by Sister Zeus
Emergency Contraception Feminist Women's Health Center
MoonDragon's Contraception Information: Emergency IUD
MoonDragon's Contraception Methods Compared
Sister Zeus: Emergency Contraception
Sister Zeus: A Plan of Action - What Can I Do Now?
MoonDragon's Contraception Information: Oral Contraceptives (The Pill)
MoonDragon's Contraception Methods Compared
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