Emergency contraception

Emergency contraception or a pill the next morning

Emergency contraception means any method of preventing unwanted pregnancy used after sexual intercourse or before implantation of the embryo into the lining of the uterus. The effectiveness of emergency contraception is 75-89%.

Basically, emergency contraception is reduced to two methods – a hormonal method known as a pill after sex, or the introduction of a copper-coated (metal) intrauterine device. A pill after sex is one dose of 1500 mg of levonorgestrel or 2 tablets of 750 mcg, taken at intervals of 12 hours. It is also possible to prevent unwanted pregnancy by injecting an IUD within 5 days after unprotected sexual intercourse.

The mechanism of action of hormonal contraception is based on the hypothesis that a high level of levonorgestrel disrupts the maturation of ovarian follicles and interrupts ovulation. It is important to clarify that pills after sex work only when ovulation has not yet occurred. If taken after or during ovulation, there is no effect.

The effect also decreases with increasing intake time after sex. Levonorgestrel prevents 95% of pregnancies if taken in the first 24 hours after sexual intercourse, and decreases to 85% within 24-48 hours. Repeated use of hormonal emergency contraception after each sexual intercourse without precautions reduces the effectiveness of the method.

The pill after sex has some side effects, the most common of which are nausea, vomiting, fatigue, and dizziness. Therefore, together with levonorgestrel, it is recommended to take antiemetics (for example, metoclopramide). If a woman vomits during the first two hours after taking the pill, a second dose should be taken.

IUD is also used as emergency contraception when administered up to 5 days after sexual intercourse, and the effectiveness of the method is more than 98%. The principle of the IUD is to reduce sperm motility and create aseptic inflammation of the uterine mucosa, which makes it impossible to implant an embryo.

There are no contraindications to the use of emergency contraception. However, when an intrauterine device is inserted, it is necessary to confirm the absence of an existing pregnancy and signs of genital infection in order to prevent its spread into the uterus.

Side effects of the IUD are associated with the placement of the device. Bleeding and abdominal pain are common after administration, and the most serious event that can occur is uterine perforation, but this occurs in less than 1 in 1000 cases.

A woman is recommended to take a urine pregnancy test if she does not notice normal menstruation for the next 21 days. It is important to emphasize that emergency contraception, regardless of what it is, protects against intrauterine pregnancy, as well as ectopic pregnancy.