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Contraception

Emergency contraception: know your options

Emergency contraception is just that. Something you take (or do) to prevent a pregnancy when you have unprotected intercourse. Emergency is a fitting way to describe this form of contraception because A) if you don’t want to be pregnant, well, it is a freaking emergency, B) you need to act urgently to protect yourself, and C) hopefully unprotected sex is not happening on a regular basis.

In an ideal world everyone is using a highly reliable form of contraception and so these back-up methods are not needed, however, things happen. Condoms break, people get coerced into sex under the influence of alcohol or drugs, or money runs out and the pack of pills never gets picked up from the drug store.

The first thing you need to know is that you have 5 days after the “episode” to do something. The sooner the better. The clock starts ticking with penetration.

You have 3 options:

1) Plan B (or the generic), which is levonorgestrel, a progestin (synthetic hormone related to progesterone) and commonly found in many birth control pills. There is no medical condition where Plan B is contraindicated and even if you are pregnant and don’t know it levonorgestrel will not harm your baby. he most common accepted way that Plan B works is inhibiting ovulation. No egg, no pregnancy. If you are 17 and older you can buy it over the counter (the generic is about $30 and the brand name $60, more expensive than a pack of birth control pills at Planned Parenthood but way cheaper than a pregnancy). The sooner you take Plan B, the better, although you can take it up to 72 hours after unprotected sex. Plan B reduces your risk of pregnancy by about 80%, meaning if 100 women have unprotected sex and take Plan B, two will get pregnant (the pregnancy rate is 2.19%). Take it within 48 hours and the results are even better. Because of the safety of Plan B, many reproductive health advocates (including me) recommend buying a pack in advance (if you can afford it) and keep it in your purse or medicine cabinet. If you never need it, you might have a girlfriend who does.

2) Ella, which is a drug called ulipristal, a prescription medication that blocks progesterone. Ella also works by preventing ovulation and you can take it up to 120 hours after intercourse, but it does not lose its efficacy once the clock starts ticking. Unlike Plan B, if you happen to be pregnant the effects of Ella on the baby are unknown so your doctor needs to make sure you are not pregnant (either by asking you questions about your last period or two or by doing a pregnancy test). If you are calling for Ella, make sure you know your menstrual cycle history for the past 1-2 months. Ella is more expensive than Plan B (even the brand name Plan B and about three times more expensive than generic Plan B); however, it is more effective. If 100 women have unprotected intercourse at take Ella only 1 will get pregnant (the pregnancy rate is 1.28%), so about twice as effective as Plan B.

3) Copper IUD. Yup, have this inserted within 120 hours of unprotected sex and you have essentially 100% emergency contraception protection PLUS 10 years of worry free contraception. The cost will vary from just your office co-pay to several hundred dollars if you have insurance. The copper IUD works by killing sperm, pure and simple. You can’t have the IUD inserted if you might  be pregnant or if you have an active infection in your cervix (gonorrhea or chlamydia). The other advantage is for the next 10 years you don’t have to think about emergency contraception again, and when it comes time to plan your pregnancy, just have the IUD pulled and your fertility returns to normal the next cycle.

Make sure you have an emergency contraception plan, because condoms breaks, pill packages get forgotten, and unfortunately, unplanned and even unwanted sexual events happens.

Discussion

2 thoughts on “Emergency contraception: know your options

  1. I have seen online regimens that involve taking multiples of the contraceptive pill as an emergency contraceptive. E.g.: http://ec.princeton.edu/questions/dose.html. Do you have opinions on those for people who can’t access other forms of emergency contraception?

    Posted by QoB | January 11, 2012, 8:34 am
  2. Thank you very much, all my doubts have been lifted.

    Posted by Nlara | January 12, 2012, 7:03 pm

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