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Life is full of unexpected twists, and when it comes to intimate encounters, being prepared is vital. Emergency contraception provides options to prevent unintended pregnancies, even when regular birth control methods have failed. In this blog post, we shall empower you with the knowledge of the various types of emergency contraception available to you. This information will enable you to make more informed decisions regarding your reproductive health and embrace sexual empowerment.

One-Step Levonorgestrel – The Swift Saviour1

A single pill, containing 1.5 mg levonorgestrel (LNG), is taken as soon as possible after the unprotected/unintended sexual encounter or with contraceptive failure. For best results it should be taken within 72 hours (3 days) and is most effective the sooner you take it within those 72 hours (3 days).

Two-Step Levonorgestrel – The Swift Sisters1

This is essentially the same as option one, except that the 1.5 mg dose of LNG is split into two doses of 0.75 mg each. Start with the first pill taken as soon as possible after unprotected/unintended sexual intercourse and the last pill within 12 hours after the first one. Make sure to take both pills within the 72-hour time frame. This split-dosing has been shown to have less side effects (nausea) when compared to Option 1 (single-dose) with no difference in efficacy.2

How do Levonorgestrel Pills Work?3

These pills act by delaying ovulation. This means that the pills prevent the release of an egg cell from the ovary, which needed for fertilisation by the sperm cell – thereby reducing the chances of a pregnancy.

How effective is Levonorgestrel?

Levonorgestrel is said to be 95% effective in preventing pregnancies when taken within 24 hours of sexual intercourse; 85% if taken within 25–48 hours (1-2 days), and 58% if taken within 49–72 hours (2-3 days).4

Figure 1, below, indicates the difference in efficacy of LNG vs UPA intake since unplanned sexual intercourse.

Ulipristal Acetate – The Hero of Hormone Regulation1,5

Ulipristal acetate (UPA) is mostly known for being effective up to five days after unprotected intercourse (110 hours). A single 30 mg dose is to be taken at once.

How do Ulipristal Acetate Pills Work?3

These pills act by delaying ovulation by up to five days. This means that the pills prevent the release of an egg cell from the ovary, which needed for fertilisation by the sperm cell – thereby reducing the chances of a pregnancy.

How Effective Is Ulipristal Acetate?

Ulipristal Acetate is the most effective emergency contraceptive pill when taken within the first 24 hours after unplanned sexual intercourse or failure of a barrier method (e.g. condoms), and remains 98% effective for up to 5 days.4,5

Figure 1: A comparison of levonorgestrel (LNG) vs Ulipristal Acetate (UPA) intake after an unplanned sexual encounter

Must Levonorgestrel and Ulipristal Acetate Be Prescribed or Can I Buy Them Over the Counter?

In South Africa, both LNG and UPA emergency contraceptive pills are available over the counter without a prescription.

Copper Intra Uterine Device – A Long Term Solution 1,5,6

The copper intra uterine device (IUD), provides the most effective emergency contraception as well as being a long-term contraceptive method. This method of emergency contraception is not as easily accessed as the emergency contraceptive pills because the copper IUD must be inserted vaginally into your uterus by a healthcare provider within five days of unprotected sex. The advantage to this method is that it offers ongoing protection for up to ten years.

How Does the Copper IUD Work?7

The copper IUD creates a hostile environment in the uterus. This means that the copper ions (released by the IUD) impair sperm motility and function, thus preventing fertilisation of the egg. The copper IUD acts inhibits implantation – This means that the presence of copper in the uterus makes it challenging for a fertilised egg to implant in the uterus walls, thereby reducing the risk of pregnancy.

How Effective Is The Copper Intra Uterine Device?

The copper IUD, provides the most effective emergency contraception option and is 99% effective and additionally acts as a long-term contraceptive method.

Being Street Wise – Important Information to Know1,5,8

Act Swiftly: Emergency contraception is most effective when taken as soon as possible after unprotected intercourse. The sooner you act, the better the chances of preventing pregnancy are.

Not for Regular Use: Emergency contraception is designed for occasional use and should not replace regular birth control methods … which are more reliable in preventing pregnancy. Not to be used more than once a month.

Safe Backup: Emergency contraception does not protect against sexually transmitted infections (STIs) … so always use condoms to reduce the risk of STI’s in addition to emergency contraception.

Temporary Side Effects: Some women may experience nausea, vomiting, or irregular bleeding after using emergency contraception … these side effects are generally short-lived and are not a cause for concern.

Existing Pregnancies: Emergency contraception will not terminate an existing pregnancy, as they are not abortion pills … it is only effective in preventing pregnancy before it occurs and has no effect on future fertility.

Use alternative barrier methods (condoms, etc.) after taking the morning after pill till you have your next period, then continue on your normal oral contraceptive or use condoms.

Emergency contraception empowers you to take charge of your reproductive health in unplanned moments. Understanding your options is vital for making informed choices. Remember, emergency contraception is not intended for regular use, so discuss long-term contraceptive options with your healthcare provider for ongoing protection. Embrace empowerment, act decisively, and safeguard your reproductive health with confidence, knowing that you have a lifeline in moments of uncertainty.

Disclaimer: The information provided in this post is for educational purposes only and should not substitute professional medical advice. Consult a healthcare professional for personalised guidance regarding contraception options.

References:

  1. World Health Organisation. (2021). Emergency Contraception. Retrieved from https://www.who.int/news-room/fact-sheets/detail/emergency-contraception
  2. Contraception Journal. (2002). Comparative evaluation of the effectiveness and safety of two regimens of levonorgestrel for emergency contraception in Nigerians. DOI: https://doi.org/10.1016/S0010-7824(02)00337-2. VOLUME 66, ISSUE 4, P269-273.
  3. Data on file.
  4. Lancet. (2010). Ulipristal acetate versus levonorgestrel for emergency contraception: a randomised non-inferiority trial and meta-analysis. 375: 555–62. DOI:10.1016/S0140- 6736(10)60101-8.
  5. Terrence Higgins Trust. Emergency Contraception (2021). Retrieved from https://www.tht.org.uk/hiv-and-sexual-health/sexual-health/improving-your-sexual-health/contraception/emergency
  6. American College of Obstetricians and Gynaecologists. Emergency Contraception. (2015). Retrieved from https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2015/09/emergency-contraception
  7. Healthline. (2021). Everything You Need to Know About the Copper IUD (ParaGard) Retrieved from https://www.healthline.com/health/birth-control/copper-iud
  8. Planned Parenthood. Which kind of emergency contraception should I use? Retrieved from https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception/which-kind-emergency-contraception-should-i-use Editor: Dr Liesl Brown Ph.D