Emergency contraceptive, or post-coital contraceptive, refers to methods of contraception that can be used to prevent pregnancy in the first few days after intercourse. It is intended for emergency use following unplanned intercourse, contraceptive failure or misuse (such as forgotten pills or torn condoms).
Emergency contraceptive can prevent most pregnancies when taken after intercourse.
The emergency contraceptive pill regimen recommended by WHO is one dose of levonorgestrel 1.5 mg, taken within five days (120 hours) of unplanned intercourse. Emergency contraceptive is effective only in the first few days following intercourse before the ovum is released from the ovary and before the sperm fertilizes the ovum. Emergency contraceptive pills cannot interrupt an established pregnancy or harm developing embryo.
Who needs emergency contraceptive pills?
Any woman of reproductive age may need emergency contraceptive at some point to avoid an unwanted pregnancy.
Emergency contraceptive can be used in a number of situations following sexual intercourse:
- When no contraceptive has been used.
- When there is a contraceptive failure or incorrect use, including:
- Condom breakage, slippage, or incorrect use.
- Three or more consecutively missed combined oral contraceptive pills.
- Lactating mother whom take daily contraceptive pills.
- Non lactating women whom take daily combined oral contraceptive pills and miss 3 or more consecutive days.
- Progestogen-only injection taken more than two weeks late.
- The combined estrogen-plus-progestogen monthly injection taken more than seven days late.
- Failed withdrawal (e.g. Ejaculation in the vagina or on external genitalia).
- Failure of a spermicide suppository to melt inside vagina.
- Miscalculation of the periodic abstinence method, or failure to abstain or use a barrier method on the fertile
days of the cycle.
- Expulsion or partial movement of an intrauterine contraceptive device (IUD)
Emergency Contraceptive Pills
WHO recommends levonorgestrel for emergency contraceptive pill use. Ideally, this progestogen-only method should be taken as a single dose (1.5 mg) within five days (120 hours) of unplanned intercourse. Alternatively, a woman can take the levonorgestrel in two doses (0.75 mg each; 12 hours apart).
Mode of action:
Levonorgestrel emergency contraceptive pills prevent pregnancy by preventing or delaying ovulation. They may also work to prevent fertilization of an egg by affecting the cervical mucus or the ability of sperm to bind to the egg. Levonorgestrel emergency contraceptive pills are not effective once the process of implantation has begun, and they will not cause abortion.
Levonorgestrel-alone emergency contraceptive pills are very safe and do not cause abortion or harm future fertility.
Undesirable-effects are uncommon and generally mild.
Medical eligibility criteria and contraindications:
Emergency contraceptive pills prevent pregnancy. They should not be given to a woman who already has a confirmed pregnancy. However, if a woman inadvertently takes the pills after she becomes pregnant, the available evidence suggests that the pills will not harm either the mother or her fetus. Emergency contraceptive pills are for emergency use only and are not appropriate for regular use as an ongoing contraceptive method because of the higher possibility of failure compared with non-emergency contraceptives. In addition, frequent use of emergency contraceptive can result in side-effects such as menstrual irregularities, although their repeated use poses no known health risks. There are no medical contraindications to the use of levonorgestrel emergency contraceptive pill.