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Emergency Contraception Update, 2011

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You are scared about a recent sexual encounter, and wonder if you have a chance of pregnancy. Is it worth getting emergency contraception, or just hope for the best?

Emergency contraception pills (ECP) are an option for many women. Whatever the reason for your "pregnancy scare", you can use ECP within 120 hours (5 days) after unprotected sex to decrease your chances of unintended pregnancy. It is safe, effective, available without prescription for women (and men can purchase it, too) for those 17 and older in the U.S.

ECP is highly effective for a "last chance" pregnancy prevention. Depending on many variables, most reports "estimate effectiveness of ECPs (reduction in a woman's chance of pregnancy) are between 56% to 89%". (Trussel, et al.) Compared this to condoms at (up to) 98 percent effective, and birth control pills at 99 percent effective, ECPs are effective but are not recommended for frequent use because they are not as effective other forms of birth control pills (BCP).

ECPs have been proven safe for women. They also are safe for the fetus, as if you are already pregnant, they do not terminate a pregnancy. "ECPs will not work if a woman is already pregnant, and will not harm the woman or her fetus. There is no time when the emergency contraceptive pills available in the United States would end a pregnancy once it has started. Hormonal emergency contraceptive pills don’t have any effect if you are already pregnant." (Princeton University)

Similarly, ECPs and BCPs also have not shown to have any teratogenic effects (birth defects) if taken by women who are already pregnant.

You may have the following non-harmful side effects after using ECP:

  • period that is longer in duration
  • period that begins a week early
  • period that begins a week late (we know...bad timing for a late period)!!!
  • breakthrough bleeding (bleeding or spotting that occurs in-between period)
  • nausea (resolves within a 24-48 hours)
  • vomiting (if vomiting occurs within 2 hours after taking a dose, some clinicians recommend repeating a dose)

Many women want to know when they can expect their next period after taking ECPs. Some women experience bleeding, and are confused if it is their period (thus they can relax knowing that they are not pregnant), or a side effect. After taking ECP, If you experience:

  • Early bleeding, and unsure if it is your period or breakthrough bleeding: Wait until your expected period. You may take a home pregnancy test if your regularly-expected period does not begin. If your period begins as expected or a week late, you are not pregnant.
  • Late or missed period: Wait another week for your period, or take a home pregnancy test (HPT). The ECP can cause menstrual changes, including late period. A HPT will not be accurate until after your expected period.
  • Light bleeding or spotting; different from period: This could be breakthrough bleeding or early period. Again, wait for your expected period to begin, and if it does not (if it is late), take a home pregnancy test.
  • As you can see, no matter what your situation with your irregular or different "bleeding pattern", you will still need to wait until your regularly scheduled period, and if it is late, take a home pregnancy test to confirm. We know this two week wait is excruciating and anxiety-provoking, but please hang in there, as it is a process that takes 10-14 days.

    ECPs work in the same way as BCP, and are thought to work primarily by preventing ovulation. They may also work by altering the lining of the uterus to prevent implantation, or by thickening the cervical mucus (to impair sperm's ability to travel).

    ECP works within 120 hours (5 days) after unprotected sex, and has a higher success rate if taken as soon as possible after unprotected sex. According to Planned Parenthood, "Plan B One-Step and Next Choice reduce the risk of pregnancy by 89 percent when started within 72 hours after unprotected intercourse."

    ECPs are available over-the-counter (OTC) without prescription in many countries. Plan B One-Step and Next Choice were approved by the FDA as a nonprescription drug for women and men 17 and older. (ECP is available from a Pharmacist; not on pharmacy shelves). Women and men younger than 17 may get a prescription from a health care provider. It may be an added barrier to ask the Pharmacist for ECP, but if you need it...please do not be too embarrassed to ask!

    - Emergency Contraception: A Last Chance to Prevent Unintended Pregnancy. by James Trussel, Ph.D and Elizabeth G. Raymond, MD, MPH. September 2010.

    - Planned Parenthood: Morning After Pill

    - Bulletin of the World Health Organization (WHO) 2010; 88:243-243. Emergency Contraception: dispelling the myths and misperceptions. by Elizabeth Westley and Anna Glasier.

    - The Emergency Contraception Website: Princeton University

Add a Comment2 Comments

EmpowHER Guest

Hi everyone I need help, I have a question and hopefully someone could abswer. I had protected sex a day after I had my period. My period last a week but I don't have a normal cycle. After having unprotected sex I took plan b the morning after because my partner had came in side me and that same day I took the pill we had unprotected sex again and he accidentally came inside me again. A week after I start having real bad cramps and start my cycle again after I had already had it a week ago that had over happen to me I have 2 days of heavy bleading my breast hurts I get tired I grave. Could I be pregnant? Even if I am bleading. Should I take pregnancy test. Please help

September 24, 2011 - 6:35am
EmpowHER Guest
Anonymous (reply to Anonymous)

hey what happened are you ok? I did research and it seems like the tiredness,cramps, bleeding, and even nausea are common side effects of the morning after pill.

January 26, 2012 - 7:39pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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