Emergency contraceptive methods

If you have forgotten to take your birth control pill or to use a barrier contraceptive, there are so-called emergency contraceptives, which include the emergency contraceptive pill and intrauterine devices, to prevent pregnancy.

Emergency contraceptive pills (ECP) and intrauterine devices (IUDs).

There are different forms of EC. Emergency contraceptive pills (ECPs)—sometimes simply referred to as emergency contraceptives (ECs) or the morning-after pill—are medications intended to disrupt or delay ovulation or fertilization, which are necessary for pregnancy. ECPs and abortion pills are not the same. ECPs work by preventing or delaying ovulation and therefore preventing pregnancy, not by abortion. Intrauterine devices (IUDs)—usually used as a primary contraceptive method—are sometimes used as the most effective form of emergency contraception.

A variety of types of emergency contraceptive pills are available: combined estrogen and progestin pills, progestin-only (levonorgestrel, LNG) pills, and antiprogestin (ulipristal acetate or mifepristone) pills.

Emergency contraceptive pills originally contained higher doses of the same hormones (estrogens, progestins, or both) found in regular combined oral contraceptive pills. The ECP can be taken up three days after unprotected sex. Emergency contraceptive pills are an emergency solution and should not be used regularly.

A more effective alternative to emergency contraceptive pills is the copper-T intrauterine device (IUD) which is generally recommended up to 5 days after unprotected intercourse to prevent pregnancy. Insertion of an IUD is more effective than use of Emergency Contraceptive Pills – pregnancy rates when used as emergency contraception are the same as with normal IUD use. Unlike emergency contraceptive pills, which work by delaying ovulation, the copper-T IUD works by interfering with sperm motility. Therefore, the copper IUD is equally effective as emergency contraception at all weight ranges. IUDs may be left in place following the subsequent menstruation to provide ongoing contraception for as long as desired (12+ years).

Symptoms

The most common side effect of emergency contraceptive pills is nausea. Antiemetics are not routinely recommended with levonorgestrel-only ECPs. If a woman vomits within 2 hours of taking a levonorgestrel-only ECP, she should take a further dose as soon as possible.

Other common side effects (each reported by less than 20% of levonorgestrel-only users) are abdominal pain, fatigue, headache, dizziness, and breast tenderness. Side effects generally resolve within 24 hours, although temporary disruption of the menstrual cycle is commonly experienced. If taken before ovulation, the high doses of progesterone in levonorgestrel treatments may induce progesterone withdrawal bleeding a few days after the pills are taken.

Complications after having an IUD fitted are rare, but can include:

pain
infection
damage to the womb
the IUD coming out of your womb
heavier, longer or more painful periods if you continue to use it as a regular method of contraception