Emergency Contraception Demystified: A Comprehensive Guide to Postcoital Options

Woman hand holding contraceptive pills and Water

Unprotected intercourse or contraceptive failure can lead to anxiety and stress, but understanding the available emergency contraception options can help alleviate these concerns. This blog will ellaborate on various emergency contraception methods, their effectiveness, and how they work to empower you to make informed choices in such situations.

Emergency Contraceptive Pills (ECPs)

ECPs are a popular choice for emergency contraception, intended to be taken immediately after unprotected intercourse. They are available in two primary forms:

  • Levonorgestrel Pills: Over-the-counter ECPs containing levonorgestrel, such as Plan B One-Step and Take Action, can be taken within 72 hours of unprotected intercourse. They work by inhibiting or delaying ovulation and preventing fertilization. The sooner they are taken, the more effective they are.
  • Ulipristal Acetate Pills: Prescription-only ECPs containing ulipristal acetate, such as Ella, can be taken within 120 hours (5 days) of unprotected intercourse. Ulipristal acetate works by inhibiting or delaying ovulation and is equally effective throughout the 120-hour window.

It’s important to note that ECPs are not abortion pills and will not be effective if a woman is already pregnant. They are also not intended as a regular form of contraception.

Copper Intrauterine Device (IUD)

A copper IUD can be inserted within five days of unprotected intercourse to serve as emergency contraception. It works by releasing copper ions, which are toxic to sperm, preventing fertilization. Once inserted, a copper IUD can continue to provide long-term contraception for up to 10 years.

Emergency Contraception Effectiveness

The effectiveness of emergency contraception varies depending on the method and the time elapsed since unprotected intercourse:

  • Levonorgestrel Pills: When taken within 72 hours, these ECPs have an estimated effectiveness of 89%. However, the effectiveness decreases with time, and they may be less effective for women with higher body mass index (BMI).
  • Ulipristal Acetate Pills: These ECPs have an estimated effectiveness of 85% when taken within the 120-hour window. They are equally effective throughout the five days and may be more effective than levonorgestrel pills for women with higher BMI.
  • Copper IUD: With an estimated effectiveness of over 99%, the copper IUD is the most effective form of emergency contraception. Its effectiveness remains consistent regardless of when inserted within the five-day window.

Potential Side Effects

Emergency contraception may cause mild side effects in some individuals:

  • ECPs: Common side effects include nausea, headache, dizziness, abdominal pain, and fatigue. These side effects are usually short-lived and subside within a few days.
  • Copper IUD: Some women may experience discomfort during IUD insertion, and cramping or spotting may occur for a few days afterward. In rare cases, the IUD may cause heavier or longer periods.

Factors to Consider

When choosing an emergency contraception method, consider the following factors:

  1. Time since unprotected intercourse: The sooner you act, the more effective the emergency contraception will be. Levonorgestrel pills should be taken within 72 hours, while ulipristal acetate pills and copper IUDs can be used within 120 hours. Copper IUDs are the most effective option regardless of when inserted within the five-day window.
  2. Accessibility: Levonorgestrel pills are available over the counter without a prescription, while ulipristal acetate pills require a prescription. Copper IUDs must be inserted by a healthcare professional.
  3. BMI: Women with a higher BMI may find ulipristal acetate pills or copper IUDs more effective than levonorgestrel pills.
  4. Long-term contraception: If you’re considering long-term contraception, a copper IUD can provide emergency contraception and ongoing birth control for up to 10 years.
  5. Personal health: Discuss your medical history with your healthcare provider before choosing an emergency contraception method, as some conditions may affect its suitability.

Understanding the various emergency contraception options is essential for making informed decisions in the event of contraceptive failure or unprotected intercourse. Consult with your healthcare provider to determine the most appropriate method based on your unique circumstances.

Sources:

  1. Planned Parenthood. (2021). Morning-After Pill (Emergency Contraception). https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception
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  3. Planned Parenthood. (2021). IUD as Emergency Contraception. https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception/iud-emergency-contraception
  4. Princeton University. (2021). Emergency Contraception: Efficacy of Emergency Contraceptive Pills. https://ec.princeton.edu/questions/ec-efficacy.html
  5. Cleland, K., et al. (2012). The efficacy of intrauterine devices for emergency contraception: a systematic review of 35 years of experience. Human Reproduction. https://pubmed.ncbi.nlm.nih.gov/22570193/
  6. American Pregnancy Association. (2021). Emergency Contraception. https://americanpregnancy.org/preventing-pregnancy/emergency-contraception/
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  8. CDC. (2021). Intrauterine Device (IUD). https://www.cdc.gov/reproductivehealth/contraception/mmwr/mec/appendixg.html
  9. Office on Women’s Health. (2019). Emergency contraception. https://www.womenshealth.gov/a-z-topics/emergency-contraception
  10. NHS. (2020). Emergency contraception (morning after pill, IUD). https://www.nhs.uk/conditions/contraception/emergency-contraception/
  11. Glasier, A., et al. (2011). Ulipristal acetate versus levonorgestrel for emergency contraception: a randomised non-inferiority trial and meta-analysis. The Lancet. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)62246-8/fulltext
  12. American College of Obstetricians and Gynecologists. (2019). Emergency Contraception. https://www.acog.org/womens-health/faqs/emergency-contraception