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Emergency Contraception

Morning After Pill PrescriptionWhat is emergency contraception?

Emergency contraception is a method of preventing unwanted pregnancy. It is used after having unprotected sex. One can get a morning after pill prescription online. You can use this in the following cases:

 
  • If you had vaginal intercourse without using any type of contraception.
  • If you had vaginal intercourse, and you think there could be problems with the contraception you used. For example, you forgot to take your regular contraceptive pills. Or the condom split.
There are three options available for women. The first option is the progestin pill. The second option is the ulipristal acetate pill. Lastly, the third option is the Intra-Uterine contraceptive device (IUCD). The IUCD is also known as the coil.
 

Emergency contraception option 1: The progestin pill

This pill contains levonorgestrel which is a progestin hormone. The pill is sold under several brand names. But all contain the same dose of levonorgestrel. Each pill contains 1.5 mg of levonorgestrel, and the usual dose is one tablet. But, in some cases, a higher dose may be needed. These cases include:
 
  • If your weight is above 70kg (154lbs) or your BMI is greater than 26. In this case, you should take a double dose.
  • If you are taking other medicines, you may need a higher dose. Especially if you are taking anti-epilepsy medicines. We recommend that you get in touch with your doctor. As your doctor will determine the dose best suited for you.

When do I take it and how does it work?

You should take the pill as soon as you can after having unprotected sex. Importantly take the pill within 72 hours (three days). This pill works by either preventing or delaying ovulation (release of the egg from the ovary). Thus, it does not cause an abortion. In other words, it will not terminate a pregnancy. It is essential to take the pill as soon as possible. If not, it will be ineffective if ovulation has already taken place.

How effective is the POP pill?

If taken within 72 hours of unprotected sex, the progesterone pill is effective. But, after 72 hours, its efficacy decreases. Especially after 96 hours. Exact effectiveness is difficult to study. This is because not all women having unprotected sex become pregnant. Studies show that about 6% – 8% of women who have unprotected sex become pregnant. Only about 0.6% – 2.6 % of women are likely to get pregnant when taking the progestin pill. The efficacy also depends on when the pill is taken in terms of the menstrual cycle. Ovulation, for a regular 28-day cycle, happens around the 14th day. If you take the pill after ovulation, it will not work. In this case it’s better for you to contact your doctor for an IUD. You should remember that although the progestin pill is effective, it should be used in case of emergencies. It should not be a planned contraceptive method.

Are there any side effects with the emergency progestin pill?

It is uncommon to have any side effects due to the progestin pill. Yet, some women do report feeling nauseous for 24 hours after the pill. Eating something before taking the pill may reduce nausea. It may also reduce instances of vomiting. But, if you do vomit within three hours of taking the pill, then you must take another dose. You may also want to ask your doctor about a prescription for anti-nausea tablets. Or opt for the IUD. Other than this, you may experience some mild symptoms for a short time. Symptoms such as diarrhea, dizziness and breast tenderness. Further, you may experience delayed or early periods. This is because the pill contains hormones. In addition, you may witness some erratic bleeding.

Who should not take the emergency progestin pill?

While most women should be able to take the progestin pill, some may need to avoid it. For example:
 
  • If you suffer from the rare condition, porphyria, you should not take it.
  • If you suffer from severe gut disease, you should not take it. Additionally, do not take it if you have a past history of ectopic or molar pregnancy as well.
Further, do not take the progestin pill if you are taking any of the following medicines. This is because it will not work effectively. These include, for example:
 
  • Medicines for epilepsy including Phenytoin and Carbamazepine.
  • Two antibiotics called Rifampicin and Rifabutin. However, other antibiotics are safe to taken with progestin.
  • An over-the-counter remedy for low mood, known as St John’s wort.
  • Some medicines used to treat HIV and AIDS, such as Ritonavir.
Be honest and transparent with your doctor. Inform your doctor about your current medical conditions. Also inform your doctor of any medications that you may be taking. As an important note, if progestin fails to work, and you do conceive, the medicine will not in any way harm the development of the fetus.

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Emergency contraception option 2: Ulipristal acetate pill

Ulipristal acetate is a selective progestin receptor modulator. This means it is an antiprogestin. It is available under several brand names.

When do I take it and how does it work?

You must take the pill as soon as possible after unprotected sex. Its efficacy is the highest if taken within 120 hours (5 days). The earlier you take the pill, the more effective it is. The hormone works by preventing or delaying ovulation.

How effective is ulipristal acetate?

If taken within 120 hours, the ulipristal acetate pill is effective. It has a good chance of avoiding unwanted pregnancy due to unprotected sex. Its effectiveness is lower if taken beyond the 120 hour period.

While the exact effectiveness of the pill is difficult to study, the ulipristal acetate pill has been found to be effective. It is more effective than the progestin pill. Especially if taken after the first 72 hours. However, the effectiveness of the pill may be lower in women who weigh more than 85kgs (187lbs). Additionally, it may be lower in women whose BMI is above 30.

If one takes the pill after ovulation, it will not work. It is better for you to contact your doctor for an IUD. For a regular 28-day cycle, ovulation happens around the 14th day. Although the pill is effective, only use it in emergencies. It should not be a planned contraceptive method.

Who should not take ulipristal acetate?

You must avoid taking this pill if you suffer from severe asthma. Lactating mothers should avoid feeding for one week after taking the pill. Express and discard breast milk so that your milk supply remains unaffected.
 
Certain medications reduce the effectiveness of ulipristal acetate. Therefore, it is better you use other forms of emergency contraception if you are taking any of these medications. Medications which may interfere with this pill include, for example:
 
  • Contraceptive pills containing progestogens. Pills that contain progestin. Progestin-only pills and combined oral contraceptive pills reduce the effectiveness of ulipristal acetate. Therefore, you must ensure that you have not taken contraceptive pills in the past week. This includes pills such as your regular planned contraceptive pill. It also includes the emergency contraceptive pill containing levonorgestrel as well. Further, after taking the ulipristal acetate pill, you must not take any contraception pill for five days.
  • Medicines for epilepsy including Phenytoin and Carbamazepine.
  • Two antibiotics called Rifampicin and Rifabutin. Other antibiotics are safe to take with progestin.
  • An over-the-counter remedy for low mood, known as St John’s wort.
  • Some medicines used to treat HIV and AIDS, such as Ritonavir.
Be sure that you are honest and transparent with your doctor. Share your current medical conditions. Also, share any medications that you may be taking.
 

Are there any side effects of ulipristal acetate?

It is uncommon to have any side effects with the ulipristal acetate pill. However, there are some instances of side effects. Side effects such as headaches, nausea and abdominal pain. Dizziness and muscle pains are also side effects as well. You may witness some changes in your menstrual cycle. Changes such as periods arriving earlier or later than usual. Furthermore, you may experience some erratic bleeding. If you vomit within three hours of taking the ulipristal acetate pill then you must take another dose.

Emergency contraception pills could be less effective in the following situations:

  • If taken after ovulation.
  • If one takes the progestogen pill more than 72 hours after unprotected sex. Furthermore, if one takes the ulipristal acetate pill more than 120 hours after.
  • You vomit within three hours of taking the pill and do not take another dose.
  • If you also had unprotected sex at an earlier time since your last period.
  • If you have unprotected sex again after taking emergency contraception.

Some other important points about emergency contraception

  • Visit your doctor if you experience abdominal pain or abnormal bleeding within 2-6 weeks of taking emergency contraception. These could be the signs of an ectopic pregnancy (which is rare).
  • Most women should have their next period at the usual time. The period might have minor delays or be a few days earlier. However, you should visit your doctor if your period is late by a week or more. Also, visit your doctor if they’re lighter than usual.
  • Your next menstrual cycle may also be shorter or longer than usual.
  • There is always a small risk of pregnancy. Even if you use an emergency contraceptive correctly.
  • You should take a pregnancy test three weeks after having unprotected sex. This is to be sure the emergency contraception has worked.
  • If taking the ulipristal acetate pill, ensure that you do not start your regular contraceptive pills immediately
  • You may want to visit a doctor to know which regular contraceptive method may suit you and your partner.

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