Let’s Talk Contraception: Emergency Contraception

The Centers for Disease Control and Prevention (CDC) recently reported that 1 in 9 American women — 11 percent — has used the “morning-after pill.” This means that in the United States, 5.8 million sexually active women between the ages of 15 and 44 have used emergency contraception, an increase in use of 4.2 percent from 2002. Most women say their reasons for using emergency contraception are because they engaged in unprotected sex or feared that their method of contraception failed.

The best way to prevent pregnancy is reliable birth control. But sometimes we need a back-up method.

It has also been reported that half of all pregnancies in the United States are unintended. For that reason, the availability of a range of contraceptive options is very important. Emergency contraception is the last choice for a woman to decrease her chance of becoming pregnant after unprotected sex. There are several products available for emergency contraception in the United States. There are many options, and they include:

  • regular birth control pills in specific doses
  • PlanB One-step
  • Next Choice
  • ella
  • copper IUD or intrauterine device (Paragard)

The Yuzpe regimen, which used ordinary birth control pills in specific combinations, was named after a Canadian physician who developed the method in the 1970s. Several brands of birth control pills are approved for this use to prevent pregnancy. This method uses the combined estrogen and progesterone hormones in your regular birth control pills in certain prescribed combinations.

Research showed the progesterone component of contraceptive pills was most effective at preventing pregnancy, so Plan B was developed as a two-pill regimen of levonorgestrel (a type of progesterone). When Plan B was first released, it consisted of one pill taken as soon as possible and another taken 12 hours later. Plan B One-Step, the newest version of Plan B, now has the same dosage of levonorgestrel in just one pill. It should be taken as soon as possible after unprotected sex. This one-dose regimen has been shown to be more effective with fewer side effects.

Plan B One-Step and its generic counterpart, Next Choice, both contain levonorgestrel. When used for emergency contraception, the pill should be taken immediately after or up to 120 hours (five days) after unprotected sex. Studies show that using levonorgestrel reduces the chance of pregnancy by about half, compared to doing nothing.

You do not need an exam or lab test to use Plan B. It has been shown to be remarkably safe. Nausea is the most common side effect and if you vomit within a few hours of taking the pill, you may need to retake the dose. Plan B will not prevent or stop a pregnancy that has already begun — and studies have shown that it will not harm the developing fetus in the case that pregnancy has already occurred. No followup exam is needed after using Plan B, but if you do not have your period within three weeks after taking it, see a health care provider for a pregnancy test.

Currently, Plan B is available without a prescription to anyone 17 years of age or older. However, in April the Food and Drug Administration approved Plan B One-Step for anyone 15 years of age and older, and the Obama Administration recently dropped its efforts to retain age limits on the drug, so the minimum age could be lowered soon. It is usually necessary to ask your pharmacist for the product and show proof of your age. It can be sold to anyone, regardless of gender. Costs range from $35 to $60. Use it after each unprotected act of vaginal intercourse.

ella, an antiprogestin called ulipristal acetate, is also available as a prescription for emergency contraception. It was approved in Europe in 2009 and became available in the United States in 2010. It is effective, well-tolerated, and works especially well if ovulation is about to happen. ella is possibly more effective than levonorgestrel at delaying ovulation and thereby preventing pregnancy, but you must obtain a prescription to get it.

Remember, hormonal emergency contraception methods, like Plan B, Next Choice, or ella, are not meant to be used as a routine contraceptive method, so be sure to look into other, more reliable birth control options. Additionally, obesity may lower the effectiveness of hormonal emergency contraception. The “morning-after pill” can also be accompanied by side effects, raising the question: Are there non-hormonal options?

The answer to that question is: Yes! The copper IUD is inserted up to five days after unprotected sex to prevent pregnancy and can remain in place as contraception for 10 years. It is a good choice for women who do not want to take a pill every day or use hormones since this IUD is hormone free. However, it is not a good choice for a woman with a sexually transmitted disease or infection. It can be inserted or removed in a doctor’s office.

We are all entitled to the most correct and up-to-date scientific information available about all contraceptives. For sexually active women, the best way to prevent pregnancy is to use regular and effective birth control. But there are times when it’s good to have a back-up method to prevent pregnancy. Unfortunately, the use of emergency contraception has become a politically controversial issue for some conservatives, but this will be discussed in a future article.

For more information about emergency contraception, check out Planned Parenthood’s website or Princeton University’s emergency contraception website. You can also talk to the health care providers at your nearest Planned Parenthood, where emergency contraception is available for purchase.

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