Emergency contraceptives refers to methods that women can take to avoid pregnancy after having sex. Depending on the form and timing of administration, emergency contraceptives have varied degrees of success.

When used within 5 days of intercourse, emergency contraception (EC) can prevent up to 95% of births, but they work better the sooner they are used after sexual intercourse.

Emergency contraceptives can be used in the following situations: 

  • Unprotected intercourse, 
  • Worries about probable contraceptive failure,
  •  Inappropriate contraceptive usage, and 
  • Sexual assault without contraceptives
  • When no method of birth control has been used.
  • When there is a chance of contraceptive failure due to improper or wrong use, such as a broken, slipped, or wrongly used condom; 
  • Three (3) or more missed combined oral contraceptive pills in a row or 3 days late during the first week of the cycle; more than 3 hours late from the usual time of taking the progestogen-only pill (mini-pill) or more than 27 hours after the last pill; more than 12 hours late from the usual time of taking the intrauterine contraceptive device (IUCD)
  • More than 2- 4 weeks delay in going to get the injectible contraceptive as supposed.
  • Dislodgment, breakage, tearing, or early removal of a diaphragm or cervical cap;
  • Failed withdrawal (ejaculation)
  • A woman may be given emergency contraceptive, ahead of time to make sure she has them when she needs them and can take them as soon as possible after unprotected intercourse.

How Emergency Contraceptives Work:

Emergency birth control pills stop or delay ovulation, which stops pregnancy. 

They do not cause an abortion. 

The IUCD with copper stops fertilization by changing the chemistry of the sperm and egg before they meet. 

Emergency contraception can’t stop a pregnancy that’s already happening or hurt an embryo that’s growing.

Types of Emergency Contraceptives:

There have been several different emergency contraceptive methods available, thus-

  • The Copper T380 IUCD 
  •  Combined Oral Contraceptives pills (containing estrogen and progesterone)
    • Examples –
      • estradiol + dienogestrel
      • ethinyl estradiol + drospirenone
      • ethinyl estradiol + levonorgestrel
  • Progesterone-only pill 
    • Examples – 
      • Ulipristal acetate, 
      • levonorgestrel.
The most effective method of emergency contraception is the copper intrauterine device (IUCD)

The most effective method of emergency contraception is a copper-bearing IUCD.

Advantages

  • Women of reproductive age who engaged in unprotected sexual intercourse within 120 hours after doing so, regardless of the menstrual cycle, can go for emergency contraception. However, best of results are recorded when taken within the first 72hours of having unprotected sexual intercourse.
  • The most effective method of emergency contraception is the copper intrauterine device (IUCD). It may be implanted up to 7 days after unprotected intercourse. IUD insertion dramatically lowers the chance of pregnancy after unprotected sexual intercourse by more than 99%.
  • Ulipristal acetate is more effective than levonorgestrel, and can be taken even 5 days of having unprotected intercourse.

Disadvantages

  • Anxiety, weariness, headache, Vomiting, breast soreness, slight changes in menstruation, dizziness, and nausea are some of the adverse effects.
  • Once a fertilized egg has implanted, emergency contraception is no longer effective.
  • Levonorgestrel’s efficacy is reduced in women who weigh more than 165 pounds.

Success Rate:

The Copper T380 IUCD is a veryeffective method of emergency contraception, with a failure rate of only 0.09%, almost 99.9% success rate.

 Combined Oral Contraceptives pills – is equally very effective with 99.9% success rate.


More About The Copper (Copper T380) IUCDs

An emergency contraceptive, the Copper T380 can also be implanted within 5 days following the initial act of unprotected intercourse. If the day of ovulation can be predicted, the Copper T380 can also be implanted more than 5 days after a sexual encounter as long as ovulation is not more than 5 days following the insertion.

Copper IUCD Should Not Be Used in The following Conditions-

  • If there is  current Pelvic Inflammatory Disease (PID), 
  • Puerperal sepsis, 
  • Unexplained vaginal bleeding, cervical cancer, or
  • Severe low levels of platelets in blood.
  • After a sexual assault because the woman may be at a high risk of getting an STD like chlamydia or gonorrhea. 
  • When a woman is already pregnant.

Who Should Use Emergency Contraceptives

  • Any woman or girl of childbearing age might need emergency birth control to keep from getting pregnant.
  • There are no medical conditions that make it impossible to use emergency contraception. Emergency contraception can be used by people of any age. If you want to use a copper IUD in an emergency, you have to meet the same requirements as if you wanted to use it every day.
  • How do you know when to use emergency contraception? 


When To Change To A Regular Contraceptive

After using an emergency contraceptive, women or girls can use a regular method of birth control again or start using one for the first time. When a copper IUCD is used as emergency birth control, no other birth control is needed, while if other emergency contraceptives like the pills were used, it is recommended to go back to a previous regular contraceptive or start a new one right away, such as an IUCD with copper.

Other Things To Know About Emergency Contraceptives

  • Never use emergency contraceptives as a main form of contraception.
  • Emergency contraceptives have side effects that are similar to those of birth control pills, like nausea and vomiting, light, irregular vaginal bleeding, and feeling tired. Side effects aren’t common, they’re usually mild, and they usually go away on their own.
  • If you throw up within two hours of taking a dose, you should take it again.
  • Drugs used for emergency contraceptives do not hurt the ability to have children in the future. 
  • After taking an emergency contraceptive, there is no delay before you can have children again. 
  • There are no restrictions on who can use emergency contraceptive pills because of their health.
  • Frequent use of emergency contraceptives can cause more side effects, like irregular periods, but there are no known health risks from using it more than once.
  • It was found that emergency birth control pills work less well for women with a high body mass index of more than 30 kg/m2. However, there are no safety concerns. When they need it, obese women shouldn’t be kept from getting emergency birth control.
  • Women who are more likely to get STIs can have an IUCD put in, but some women who are very likely to get STIs shouldn’t have an IUCD put in until they get the right testing and treatment.
  • All women and girls who might get pregnant by accident should be able to get emergency contraceptives, and these methods should be a regular part of all national family planning programs. 
  • Also, emergency contraceptives should be part of health care services for people who are most likely to be exposed to unprotected sex. This includes care for women and girls who have been sexually assaulted and services for women and girls who live in emergency and humanitarian settings.

 

References 

https://www.who.int/news-room/fact-sheets/detail/emergency-contraception

https://emedicine.medscape.com/article/2172292-overview