Emergency postcoital contraception or emergency contraception refers to contraceptive measures taken after sex, which may prevent pregnancy.
They include emergency contraceptive pills (ECP’s) referred to as emergency contraceptives or the “morning-after pill”, which are drugs that prevent ovulation or fertilization and possibly post-fertilization as well. They are different from medical abortion methods that act after implantation; and intrauterine devices, which are usually used as primary contraceptive methods but are also at times used as emergency contraceptives.
Emergency contraceptives are intended for occasional use, when the primary means of contraceptives fail.
The progestin-only method uses a dose of 1.5 mg of progestin levonorgestrel, either as two 750 mµg doses in a time gap of 12 hours each, or more recently as a single dose. The combined or Yuzpe method uses large doses of both estrogen and progestin. This method is less effective and less well tolerated than progestin-only.
Mifepristone may be used either as an ECP or as an abortifacient, depending on whether it is used before or after implantation. As an emergency contraceptive, a low dose of it is slightly less effective than higher doses, but the lower dosage has fewer side effects. The pills are, however, not approved for emergency contraception use in the United States. Higher doses of this drug can disrupt implantation and is proven in terminating established pregnancies.
The effectiveness of emergency contraceptives has a different yardstick to that of standard methods of birth control. It is normally rated as a percentage of reduction in pregnancy rate with a single dose of emergency contraceptive. The effectiveness of different regimens vary, even that for a single dose.
In both regimens, the maximum effectiveness is within 12 hours of intercourse. A reasonable measure of effectives has been noticed even 5 days post intercourse.
The most common side effect is nausea. Sometimes, disruption of the menstrual cycle has been noticed.
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