Emergency Contraceptives

From UBC Wiki

Emergency contraceptive is a method of birth control that can be used to help prevent a pregnancy after having unprotected sexual intercourse or after it is believed that an already used form of birth control has failed.[1] There are various forms of birth control methods that help prevent unexpected and unwanted pregnancies, the forms of emergency contraceptives that are available are an intrauterine device (also known as an IUD) and pills.[1]

Types of Emergency Contraceptives:

Emergency contraceptives are available in two options, the first option is in pill form and the second option is an intrauterine device (IUD).

Emergency contraceptive pills, also sometimes known as ‘morning after pills’, need to be consumed within the first five days after engaging in unprotected sexual intercourse.[2] There are three different groups of emergency contraceptive pills available for use. [3] The first group are pills that are comprised of both estrogen and progestin as ingredients. The second group are pills that comprise of progestin-only and the third group are pills that are comprised of antiprogestin, which can be in the form of either mifepristone or ulipristal acetate.[3] Progestin is an artificial form of the hormone progesterone and some of the most commonly found emergency contraceptive pills include a progestin hormone that is called levonorgestrel.[1] Some of the more common brands of emergency contraceptive pills are Ella, Plan B, Take Action, and Next Choice One Dose.[2]

An intrauterine device or an IUD is a small device that is placed into a woman’s uterus. Intrauterine devices are also used for other medical reasons however, not all are used as emergency contraception.[1] Therefore, an intrauterine device that is used for emergency contraception is often labeled as a ‘copper IUD’.[4] This name is given due to the fact that copper is used to help kill sperm trying to enter the uterus after unprotected sexual intercourse.[1] The device itself is T-shaped and made from plastic with a vertical stem that has copper in it, which is released at a slow pace into the uterus, more specifically into the uterine cavity.[1] [5] The copper IUD can be put into a woman’s uterus up to seven days after having unprotected sexual intercourse to help avoid becoming pregnant.[1] Copper intrauterine devices need to be placed into a woman’s uterus by a medical doctor, nurse practitioner, or trained midwife and needs to be removed by a medical professional as well.[4]

How do they work?

Emergency contraceptive pills are taken orally and work by preventing or delaying ovulation, inhibiting fertilization, and preventing the implantation of a fertilized egg.[6] Hormones included in some of the emergency contraceptives stop fertilization by stopping the release of an egg cell from the ovaries and create a smaller chance of an egg being moved towards the uterus by the fallopian tubes.[1] Emergency contraceptive pills are believed to create thinning of the uterus wall lining, making it more difficult for a fertilized egg to be imbedded.[1]

Emergency contraceptive copper intrauterine devices are believed to work by killing sperm and stopping fertilization.[1] Sperm is unable to survive in the same environment as the copper ions slowly released into the uterus by the IUD.[5]

How effective are Emergency Contraceptives?

The effectiveness of emergency contraceptive pills is contingent on how soon after unprotected sexual intercourse the pill is taken. [7] Emergency contraceptive pills that include the progestin hormone, levonogestrel, have been tested to be up to 89 percent effective if the pill is ingested within 72 hours after having unprotected sexual intercourse.[2] Although they will be less effective after the 72 hours has passed, these types of pills can be used for up to 120 hours to help prevent unwanted or unplanned pregnancies.[2] Emergency contraceptive pills that contain ulipristal acetate can be taken within 120 hours after having unprotected sexual intercourse and will remain to be 85 percent effective.[2] Emergency contraceptive pills are less effective for women who weigh 165 pounds or more. [8] The copper IUD is effective 99 percent of the time if used within 120 hours of having unprotected sexual intercourse.[2]

Emergency contraceptives can be effective for preventing unplanned or unwanted pregnancies however, they are not effective for preventing sexually transmitted infections.[9]

Effectiveness and weight

What are the side effects of Emergency Contraceptives?

The following list provides the most common side effects associated with emergency contraceptive pills: [9] [10]

  • Nausea
  • Pain in the abdomen
  • Tiredness
  • Headaches
  • Changes in your menstrual cycle including spotting or bleeding in between scheduled periods and/or a heavier menstrual flow
  • Vomiting
  • Dizziness

A copper intrauterine device could create some abdominal cramping, an increase in the amount of days of a female’s menstrual cycle, a heavier menstrual flow, and some vaginal discharge.[1] [5]

Where can you find Emergency Contraceptives in Canada?

Rules and regulations for emergency contraceptives vary between countries. In Canada, emergency contraceptives are readily available to women and beginning in April 2005, emergency contraceptive pills no longer required a doctor to provide a prescription for them and are available in pharmacies across the country.[9] Copper intrauterine devices are available through a medical doctor, at universities, health care clinics, or hospitals.[1] It is important to note that the emergency contraceptive pill "Plan B® is kept behind the counter in Saskatchewan and is available under prescription by your pharmacist in Quebec"[11].

Emergency contraception by Country

References: