Emergency contraception

Emergency contraception is a specific birth control pill that may prevent pregnancy after unprotected intercourse. Emergency contraception is intended for occasional use as the word "emergency" implies. Emergency Contraception Pills are often referred as ECP's or EC's. The pill is commonly named Morning-after pill‎ because it is actually taken after intercourse.

Questions we could ask ourselves

How Does Emergency Contraception Work?

The role of emergency contraceptive pills (also called "morning after pills" or "day after pills") is to delay ovulation (the time in a woman's cycle when one of her ovaries releases an egg)

If emergency contraceptive pills are taken before fertilization (the point when the egg and sperm meet), they may interfere with the process of fertilizing the egg, for instance making it harder for the egg or the sperm to travel (and meet up) in the reproductive tract. You should be more precise in the role played by the compounds of the pill in the interference process

It’s also possible that emergency contraceptive pills work after fertilization, making it impossible for the fertilized egg to get implanted in the uterus. figure might be useful, more precise

Concerning the Intra Uterine Device (IUD), most of them do not affect ovulation but like emergency contraceptive pills, it can prevent sperm from fertilizing an egg. It may also prevent implantation of a fertilized egg.

Emergency contraceptive pills are not the same as the abortion pill. There is no time when emergency contraception would end a pregnancy once it has started. Emergency contraceptive pills don’t have any effect if the person is already pregnant. If she decides to have use an IUD for emergency contraception, her health care provider would test her first to confirm she is not already pregnant.

Are there different Emergency Pills?

Yes there are different types of Emergency Pills classified after the type and level of hormones they contain.

The progestin-only method

The progestin-only method also called Plan B. The package for Plan B has two emergency contraceptive pills (each containing 0.75mg of levonorgestrel), and the instructions tell to take the first one 72h (4 days) after unprotected intercourse, the second one 12h afterwards the first pill.
But there are also doses where the 1.5 mg are taken at once.

Progestin-Only Method goes under different names.

• Plan B for USA, Canada and Honduras.
• Levonelle for the U.K., Ireland, Australia, New Zealand, Portugal and Italy.
• NorLevo for 44 nations including France, most of Western Europe, India, and several countries in Africa, Asia and Latin America
• Postinor-2 for other 44 nations including most of Eastern Europe, Mexico and many other Latin American countries, Portugal, Australia and New Zealand, Israel, China, Hong Kong, Taiwan and Singapore

The combined or Yuzpe regimen

The Yuzpe Regimen uses a combination of estrogen and progestogen, it must be started within 72 hours of sexual intercourse.

What are the side effects of emergency contraceptive pills?

Side effects are more common with combined (Yuzpe) ECP regimens than with progestin-only ECP regimens. These side effects generally do not last more than 24 hours, and may be reduced for some women by providing anti-nausea medication before the emergency treatment.

Progestin-only regimen

• Nausea (23%) and/or vomiting (6%)
• Breast tenderness (8%)
• Diarrhea (4%)
• Irregular Bleeding (31%) and/or Heavy Menses (3%)
• Headache or Dizziness (11%)
• Fatigue (17%)

Yuzpe regimen

• Nausea (51%) and/or vomiting (19%)
• Breast tenderness (? %)
• Irregular Bleeding and/or Heavy Menses (? %)
• Headache or Dizziness (17%)
• Fatigue (29%)

Percentage references:

• Task Force on Postovulatory Methods of Fertility Regulation. Randomised controlled trial of levonorgestrel versus the Yuzpe regimen of combined oral contraceptives for emergency contraception. Lancet. 1998;352:428-433.[1]
• von Hertzen H, Piaggio G, Ding J, Chen J, Song S, Bartfai G, Ng E, Gemzell-Danielsson K, Oyunbileg A, Wu S, Cheng W, Ludicke F, Pretnar-Darovec A, Kirkman R, Mittal S, Khomassuridze A, Apter D, Peregoudov A; WHO Research Group on Postovulatory Methods of Fertility Regulation. Low dose mifepristone and two regimens of levonorgestrel for emergency contraception: a WHO multicentre randomised trial. Lancet. 2002;360:1803-1810. [2]

What is the difference between emergency contraception, the "Morning after pill", and the "Day after pill"?

Actually, there is no difference.

Emergency contraceptive pills are often called "morning after pills" and sometimes even "day after pills" because you can use them after sex to prevent pregnancy. Most of the time, when someone mentions “emergency contraceptive pills,” “morning after pills,” or the “day after pill,” they are talking about using the same hormones found in regular daily oral contraceptive pills to reduce your chances of becoming pregnant if you had sex without using contraception, you think your birth control failed, or you were forced to have sex.

Even though there’s no difference between these terms, calling emergency contraceptive pills “morning after pills” or “day after pills” can be misleading because you can use them right away – and you have up to 120 hours (five days) after sex to take the pills and still prevent pregnancy. That means you don’t have to wait until the morning after, and you can still use emergency contraception even if it takes you longer than the morning after to get it.
In addition to this, it is better to start using emergency contraception as soon as possible because it is most effective the sooner it is taken after sex.

How and When is Emergency Contraception used?

Is there a limit in which the emergency contraception can be used?

No, there is no actual limit in which this pill can be used, it will still be as effective to prevent pregnancy as the first time it has been used. But it is not a very good method; it is not as reliable as the pill or condoms, it produces also a lot of unpleasant side effects. On top of all it is of questionable ethical practice.

Are contraceptive pills safe?

Does the morning after pill prevent Sexually Transmitted Diseases ?

No the pill does absolutely NOT prevent infections such as STDs!

Can emergency contraceptive pills cause birth defects?

No. Emergency contraceptives do not seem to cause birth defects. Besides of statistics two main reasons support this point. First of all, Emergency Contraceptives contain the same hormones as ordinary birth control pills. Studies have shown that women who continued to take the Pill without realizing that they were actually pregnant did not cause harm to the developpement of the foetus.
Second of all, the emergency contraceptives would be taken long before the organs of the baby would start their process of organogenesis (developping organs). It is thus impossible for emergency contraceptives to lead to possible birth defects.

Does emergency contraception cause an abortion ?

No, using emergency contraceptive pills (also called "morning after pills" or "day after pills") prevents pregnancy after sex. It does not cause an abortion. (In fact, because emergency contraception helps women avoid getting pregnant when they are not ready or able to have children, it can reduce the need for abortion.)

Emergency contraceptive pills or the IUD as emergency contraception work before pregnancy begins. According to leading medical authorities – such as the National Institutes of Health and the American College of Obstetricians and Gynecologists – pregnancy begins when the fertilized egg implants in the lining of a woman's uterus. Implantation begins five to seven days after sperm fertilizes the egg, and the process is completed several days later. Emergency contraception will not work if a woman is already pregnant, and it also will not harm the woman or her fetus.

However there are some ethnic groups that consider that pregnacy starts with fertilisation and thus consider the emergency contraception as a abortion method... For further reading go to the Contraception Ethics article.

How are emergency contraceptive pills different from the abortion pill ?

The abortion pill (also known as mifepristone or RU-486), is a completely different drug from Plan B and the other brands of birth control pills that you can use for emergency contraception. Emergency contraceptive pills contain common female hormones, either progestin alone or progestin combined with estrogen. These hormones prevent pregnancy, they do not cause an abortion.

Mifepristone, which is sold in the United States under the brand name Mifeprex, belongs to a new class of drugs known as antiprogestins, which stop the development of a pregnancy once it has started (which happens once a fertilized egg implants in the uterus). This drug is approved for use in early abortions in the United States, and many other countries. At a far lower dose, mifepristone has been shown to also be effective for preventing pregnancy, like emergency contraceptive pills, but it is only available for this use in China.

If the EC pill does not work, can the hormones of the pill cause harm to the baby?

good start... maybe you should think about adding figures and more importantly, reorganize your questions and answersPierre.brawand 23 novembre 2007 à 21:50 (MET)
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