When your birth control fails – whether your condom breaks or you forget to take your pill – emergency contraception or EC can be your only way to prevent an unwanted pregnancy. Accidents happen! Here are some basics about the two types of the morning-after pill and the copper IUD for you to have in the back of your mind, so you can save yourself some stress later.
There is More Than One Type of Morning After-Pill Available in India
The levonorgestrel pill, with brand names such as iPill, is the most common emergency contraceptive in India. It works by delaying ovulation, which is the release of an egg from the ovary into the fallopian tube, and thickening the cervical mucus to act as a barrier to sperm. The levonorgestrel pill is not effective in women greater than 90kgs. There is also a newer emergency contraceptive pill containing Ulipristal Acetate, marketed as ellaOne, that is more effective than the levonorgestrel pill. It works in the same way but can work at more times during the menstrual cycle and is effective for women above 90kgs. It’s important to note that emergency contraception is not 100% effective.
Emergency Contraception is Not the Same as Abortion
Emergency contraception cannot abort a foetus if you’ve already conceived – i.e., if you are already pregnant. If you had unprotected sex, emergency contraception delays ovulation, and since there is no egg to be fertilised by your partner's semen, you decrease the chance of pregnancy. However, if you have already ovulated an egg in the hours or days before unprotected intercourse, neither types of pills will be effective.
The Morning After Pill Should Be Taken Within a Limited Time After Unprotected Sex
If you’re concerned about pregnancy after you’ve had unprotected sex, do not put off your visit to a pharmacy. You have 72 hours to take the levonorgestrel pill, but the sooner you take it, the more effective it is at preventing pregnancy. For the Ulipristal Acetate pill, you have to take it within 120 hours and its effectiveness does not diminish over the next 5 days.
If you haven't been taking your birth control pills regularly and have missed more than two pills, or have been very irregular about taking them, there's a chance that you may not be protected. Consider taking one of the emergency contraception pills if you have had unprotected sex and have not been regular about taking your birth control pills.
You Can Buy Them From Any Pharmacy
The morning-after-pill like iPill or other levonorgestrel EC pills are readily available in pharmacies, and you do not need a prescription to buy them. No pharmacy can prevent you from buying an emergency contraceptive for any reason. If you feel uncomfortable walking down to a drugstore, dial-up your nearest pharmacy and ask them to deliver it to you. When you get hold of one, be sure to check the expiry date on the label. For the Ulipristal Acetate EC pill marketed as ellaOne in India, you will need a prescription from a doctor to get it.
It may not be available in every city in India.
You May Experience Occasional Side Effects
These high-dose single tablets can cause unexpected bleeding, shifts in your cycle and spotting. So, count yourself lucky if you do not experience these problems. However, take a pregnancy test if you do not get your periods within three weeks of taking contraception because you may be pregnant.
The Pill May Not Be Effective If You Vomit
Seek medical advice if you throw up within three hours of taking the emergency pill. Vomiting would mean that the pill did not absorb in your system and therefore, may not work.
The Morning After Pill is Not 100% Pregnancy Proof
While the two morning-after pills can be extremely potent, but they won't assure you of preventing pregnancy with a 1-2% failure rate. It’s highly dependent on when you take the pill in your cycle. If you don’t get your period within 3 weeks of taking emergency contraception, be sure to take a pregnancy test.
The Most Effective Emergency Contraception is the Copper IUD
Bet you didn’t know this one! The copper IUD, or IUCD can be used as emergency contraception when placed within 5 days of unprotected sex. It is more effective at preventing pregnancy than the emergency contraceptive pills with a pregnancy rate of 0.1%. Once it gets placed, it’s then ready to go for the long haul – you don’t have to have another pregnancy scare because it’s good for 5 years, some for 10 years! You can get it removed when you’re ready to get pregnancy, and your fertility goes back to normal.
The Morning After Pill Should Not Be Used as Regular Contraception
General rule-of-thumb is only one EC pill in a cycle. If you have unprotected sex then take one of the emergency contraception pills, then have unprotected intercourse again, you should not take it again because it will probably not work. If this happens, it may be best to see your gynaecologist who can place a Copper IUD which is the most effective emergency contraception. If you find that you are taking emergency contraception more than 3-4 times in a year, you may want to consider the long-term contraception options such as the birth control pill or IUD.
Emergency Contraception Does Not Protect You Against STIs
While the two pills and copper IUD may prevent pregnancy, it won't save you from STIs. If you had unprotected sex, you would need a sexual health screening too! STIs like chlamydia and gonorrhoea can take two weeks to show up on tests, HIV and syphilis can take up to a month or more. Remember that condoms are the only way to protect yourself from STIs. Be sure you are regularly getting screened if you are sexually active.
If you have other medical problems like history of blood clots or seizures, be sure you consult a doctor prior to taking emergency contraception. If you don’t know which type of emergency contraception is best for you, or if you need a prescription for ellaOne, you can consult with our doctors at Veera.
Reviewed by Dr. Shailly Prasad, MD/MBA, and Dr. Mansi Verma, MD; Obstetrics & Gynaecology.
Disclaimer: Content on Veera is provided for informational purposes only and is not intended as medical advice, or as a substitute for medical advice given by a physician