Hello readers

I know everyone out there is very tensed again due to rising COVID cases. We might have heard, seen, or experienced the deadly face of this pandemic. The COVID vaccine is definitely giving new rays of HOPE. I myself have taken two doses and it is completely safe. I encourage everyone to have a jab when it is your turn. Obviously, safe distance and cleaning hands remain the cornerstone of fighting against corona.

Today I am going to discuss emergency contraception, which is mostly known as “ I-pill”. It is not the only way to avoid pregnancy after sexual intercourse. I come across many teenagers and young girls using the I pill as a now and then method to avoid pregnancy and we already have Dr. Google for our help. You may get instructions for how to use pills on a quick Google search but it’s a little harder to separate the facts from the popular myths. Most of the women visit clinicians only after they start facing issues with repeated use. So let's see what emergency contraception means.

Emergency contraception refers to methods of contraception that can be used to prevent pregnancy after sexual intercourse. These are recommended for use within 5 days but are more effective the sooner they are used after the act of intercourse.

The most commonly used oral emergency contraceptive regimen is the progestin-only pill( I –pill), which consists of 1.5 mg of levonorgestrel. The levonorgestrel regimen is labeled for use for up to 72 hours after unprotected sex but is best used as soon as possible after unprotected sex. It is available over the counter. The copper IUD also can be used for emergency contraception and it is highly effective if placed within 5 days of sexual intercourse. Combined estrogen-progestin emergency contraceptive regimens are no longer sold as a dedicated product.

Mechanism of Action

The mode of action varies according to the day of the menstrual cycle on which sexual intercourse occurs, the time in the menstrual cycle that the emergency contraceptive is administered, and the type of emergency contraceptive. Levonorgestrel delays follicular development when administered before the level of luteinizing hormone(LH) increases. LH hormone level increases at the time of ovulation and this is the time where chances of getting pregnant are maximum. The copper IUD prevents fertilization by affecting sperm viability and function. It also may affect the egg and uterine lining.

MYTH #1 It is sometimes confused with medical abortion.

FACT. Medical abortion is used to terminate an existing pregnancy, whereas emergency contraception is effective only before a pregnancy is established. Emergency contraception can prevent pregnancy after sexual intercourse and is ineffective after implantation. Studies indicate that hormonal emergency contraception confers no risk to an established pregnancy or harm to a developing embryo.

How effective emergency contraception in preventing pregnancy?

Insertion of a copper IUD is the most effective method of emergency contraception. The pregnancy rate is 0-2%. The Levonorgestrel regime has an efficacy rate of 85%. Bodyweight influences the effectiveness of oral emergency contraception. Levonorgestrel emergency contraception may be less effective in women who are overweight (body mass index [BMI] 25–29.9 kg/m2) or obese (BMI of 30 kg/m2 or greater).

What are the adverse effects?
  1. Nausea and vomiting

  2. Irregular bleeding - After pill use, the menstrual period usually occurs within 1 week of the expected time. Some may experience irregular bleeding or spotting in the week or month after use. If emergency contraception is taken earlier in the cycle, it is more likely that a woman will experience bleeding before the expected menses.

  3. Breast tenderness, Abdominal pain, fatigue, dizziness.

MYTH #2 Once you take the pill, you can safely have more unprotected sex.

FACT Most of the female thinks that taking a pill at one time gives protection for a whole month. Oral Emergency contraception only works to protect you against unprotected sexual intercourse you’ve already had not against future acts of unprotected sex.

MYTH #3 It’s safe to use repeatedly.

FACT Hormonal emergency contraception is less effective for long-term contraception than most other available methods. In addition, continued use of hormonal emergency contraception would result in exposure to higher total levels of hormones, and frequent use also would result in more adverse effects, including menstrual irregularities.

MYTH #4 No follow-up necessary.

FACT We need to understand that clinical follow-up is required in the following situations.

1 if menses are delayed for a week or more after the expected time

2.If lower abdominal pain or persistent irregular bleeding develops. These symptoms could indicate spontaneous pregnancy loss or ectopic pregnancy.

I would like to highlight here the fact that, emergency contraception should be followed by some other long-term contraceptive method. It should not have relied on long-term options. There are many safe contraceptive options are available. The proper evaluation and guidance will definitely help you in choosing the best option for you.

Thank you.

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Stay Safe Stay Healthy.

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