The morning after pill

Friday, December 18, 2009
Don't panic. If you've forgotten your pill, or the condom has broken, there is something you can do to prevent becoming pregnant. Contact your pharmacy, doctor or local family planning clinic as soon as possible (within 120 hours but the earlier the better).

What is emergency contraception?

There are three methods but in Australia the "progesterone only" method is the most common.

  • The "progesterone only method".
    Two Postinor-2™ pills are taken, which is similar to taking a large quantity of the mini-pill.
  • The combined pill or Yuzpe method, containing oestrogen and progestogen.
    This has been available for decades and is a high dose of "the (combined) pill". It is not used very often now that Postinor-2™ is available as the Yuzpe method tends to make women nauseous and vomiting can occur.
  • IUD insertion.
    It is only used as emergency contraception in special circumstances because usually it is used as a long-term method of contraception. Also, it may not be suitable for some women.

The "progesterone only method".
Emergency contraception should be taken as soon as possible within 72 hours of unprotected intercourse (sex). However, it can be taken up to 120 hours after unprotected intercourse but it is less effective after the 72 hours. It will not cover any pregnancy risk that may have occurred earlier in the menstrual cycle.

Postinor-2™ pills can be taken together or 12 hours apart, depending on the instructions from the provider. The recent World Health Organisation research suggests that it is just as effective taking the two pills at the same time.

Who needs it?

If a woman has had sex with a man and:

  • She/they have not used any contraception;
  • A diaphragm has dislodged;
  • A condom has broken or slipped off;
  • She has had inadequate cover on the Pill, e.g. missed pills, or is taking antibiotics, had some diarrhoea or vomiting, without using extra protection;
  • "Withdrawal" is used as a "method" of contraception (the man withdraws his penis before he ejaculates/cums inside the vagina. Some of the pre-ejaculatory fluid may contain sperm. Therefore this is an unreliable method).

How does it work?

  • By delaying/preventing ovulation;
  • By preventing a fertilised egg from implanting in the uterine wall;
  • By interrupting the production of hormones needed for pregnancy to continue.

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How effective is it?

Postinor-2™ can be 95 percent effective in preventing a pregnancy, if taken in the first 24 hours, and 89 percent effective up to 72 hours. Its ability to prevent a pregnancy decreases over time, especially after 72 hours.

It does not provide any on-going contraception and no protection against sexually transmissible infections (STIs).

Where do I get it?

Postinor-2™ is available from pharmacies without a prescription. Family planning clinics, some hospital casualty departments and some doctors still provide emergency contraception directly.

Side Effects:

  • Some women may have spotting or bleeding within the first week of taking emergency contraception; most women will have their next period within seven days of when it is usually due.
  • If the combined pill is started after taking emergency contraception, then a period may be delayed.
  • Research suggests that emergency contraception will not harm a continuing pregnancy.
  • Nausea and vomiting are uncommon with the Postinor-2™ method. If the combined method is used, anti-nausea tablets should be provided.

Note: If vomiting does occur within two hours of taking a dose of emergency contraception, the dose must be repeated. If no anti-nausea tablet was taken with the first dose, it should be used with the repeat dose.

What happens afterwards?

  • After taking emergency contraception, you should think about which contraception you would like to use in the future to prevent an unplanned pregnancy. A discussion with your doctor or family planning nurse will provide you with the information you need.
  • It is important to have a pregnancy test and sexually transmissible infection screen at your doctor, or local family planning clinic. Some STIs do not have symptoms, but they can nonetheless cause long-term complications e.g. infertility. This is why a screen for infections is important. Pregnancy testing should be performed about three weeks after taking the emergency contraception.

Will it affect my monthly period cycle?

After taking the emergency pill, most women's menstrual cycle will remain the same — provided they were successful in taking the medication in time to prevent falling pregnant. About 20 per cent will have an early period and ten per cent a late one.

  • The combined pill or mini pill can be used for contraception straight after hormonal emergency contraception.

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