Emergency Contraception (Morning After Pill/ Ipill) - Do You Know Enough??

Dr. Mamta Goel
Emergency Contraception (Morning After Pill/ Ipill) - Do You Know Enough??

In a recent survey conducted by Sexual health charity amongst women aged 16 to 54 , 59% of women said they know only ‘a little ‘ about emergency contraception (EC), while 12% said they don’t know ‘very much ‘. Meanwhile ,3% said they know ‘nothing’. Hence here are some common emergency contraception myths busted:

 

Myth : They are same as abortion pills. In the survey, 50% of the women believed that using EC causes an abortion or they weren’t sure


Fact : Emergency contraception does not disturb an ongoing pregnancy and does not cause abortion. It can only prevent pregnancy in some cases like any other contraceptive method.


However pregnancies that happen despite EC are not associated with any increased chances of fetal abnormality

 

2. Myth : EC prevents pregnancy all the times if taken within 72hrs


Fact : That’s the biggest myth that needs to be busted .It does not prevent pregnancies if the act of intercourse is after the ovulation or the LH surge which leads to ovulation within 24 to 36 hours. Oral EC cannot prevent these pregnancies even if the pill is taken immediately after intercourse. Hence pregnancies can occur despite EC pills .Also these pills act by delaying ovulation and not always inhibiting it. Therefore there are high chances of you ovulating later in the cycle and hence to get pregnant if there is UPSI (unprotected sexual intercourse) again later.


If 1,000 women had unprotected sex once, around 60 to 80 would become pregnant. If all those women had taken EC PILL , only around 11 to 26 would have become pregnant.
Also in women who get pregnant despite EC chances of ectopic pregnancies which is pregnancy outside the uterus most commonly in the tube which can be very risky and may require surgery to get rid of) are increased. Hence caution is exerted in women with previous history of ectopic pregnancy though it is not an absolute contraindication.

 

3. Myth : EC pills or morning after pill is the only type of EC


Fact : There are three types of emergency contraception available. There is an intrauterine device the CU- IUD which in fact is more effective. However more suited for married couples who have already born children and anyways need contraception for some time.

 

4. Myth : EC is only for young unmarried couples.


Fact : The other good candidates are people who have UPSI(un protected sexual intercourse) after day 21 of childbirth and not exclusively breastfeeding, couples day 5 after abortion/miscarriage and if regular contraception has been compromised

 

5. Myth : Pregnancy can occur only in mid cycle or the fertile phase. Hence one should use EC pill for UPSI done in mid cycle


Fact : Pregnancy can occur on any day of the cycle particularly in an irregular cycle. However it is unlikely to occur in first three days of periods and more likely in fertile period.

 

6. Myth : EC pills cannot be taken if usual OCP is missed


Fact : If the usual dose of OCP has been compromised like you missed it for more than 2 days or you have been irregular in taking it you can take EC pills for UPSI. Also you should start your next regular pill from the pack after 12 hous of EC pill.

 

7. Myth : Repeated use is okay and it is okay to use it as regular contraception


Fact : No long term ill effects on health are seen but in view of side effects like nausea ,vomiting ,dizziness, breast tenderness , diarrhea, period disturbance (irregular spotting and bleeding) and less efficacy especially after ovulation it is not wise to use them as a regular contraception. Do you know it has 10 times the hormone that is present in regular contraceptive pill? Also there is no protection against sexual infections

 

8. Myth : it cannot be taken again in the same cycle


Fact : It must be taken again if there is another act of UPSI as one time administration can give protection only for one act.

 

9. Myth : It cannot be taken while one is breast- feeding


Fact : Available limited evidence suggests that there is no adverse effect on breast-feeding

 

10. Myth : Repeated use can make you infertile


Fact : There are no long term effects in future fertility

 

11. Myth : People who use EC become more sexual promiscuous and there sexual risk taking increases


Fact : Studies show that this is not true

 

12. Myth : It is safe for anyone to take EC.


Fact : It is not advisable for women with medical conditions like hypersensitivity to Levonorgesterel, acute porphyria, severe liver disease, severe malabsorption syndromes or women with galactose intolerance to take these pills

 

Take home message :

  • EC is better than no contraception and Regular contraception is better than repeated EC simply because it more effective and less side effects
  • If vomiting (which is a common side effect of EC pills) occurs within 3 – 4 hours please take it again
  • Higher weight can reduce the effectiveness of EC. Consider double dose (3mg) if BMI more than 26 or weight more than 70 kg
  • You may require double dose if you are on some medicines like phenytoin or rifampicin.
  • Do a UPT if you miss your period or there is light bleeding or abdominal pain not typical of dysmenorrhea.

 

Also read: Contraception: Know Your Choices

 

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