Emergency Contraception

on . Posted in Sexual Health

Emergency contraception (EC) reduces the risk of unintended pregnancy after unprotected sexual intercourse. It can also be used when contraception may have failed, eg broken condom, missed pill and after sexual assault.

There are 2 types available in Australia. The most common form is the emergency contraception pill (the ECP), a 1.5mg dose of levonorgestrel, a progestogen hormone also found in some oral contraceptive pills. It can be taken up to 5 days after unprotected sex to reduce the risk of a pregnancy.

A copper intrauterine contraceptive device (IUD) can also be used as emergency contraception if inserted up to 5 days after unprotected sex. An IUD can then provide immediate ongoing contraception.

How does it work?
The ECP prevents or delays ovulation (release of an egg from the ovaries).

A copper IUD interferes with sperm movement and changes the lining of the uterus to prevent pregnancy.

When should I take it? How effective is it?
When taken in the first 3 days after sex, the ECP prevents about 85% of expected pregnancies. However it may still be useful if taken up to 4 or 5 days after sex. Try and obtain it as soon as possible to have the best chance of it working. A Copper IUD prevents 99% of expected pregnancies if inserted any time within 5 days of having sex.

IUD

Image above: A copper intrauterine contraceptive device (IUD)

Where do I buy the ECP?
The ECP is available without a prescription at pharmacists if you are within 3 days of unprotected sex. There are several different names for the ECP but they are all the same medication. Prices may vary. If you are having difficulty obtaining it, contact your general practitioner (GP), a family planning or sexual health clinic or a hospital Emergency Department.

Before you can be given the ECP, you will be asked a few questions to assess your risk of pregnancy and your medical history. Any personal information you share is confidential and you should be offered a private area to talk to the pharmacist. Sometimes a supply of the ECP can be made available for future use.

How do I take the ECP?
The ECP comes in a pack with either 1 or 2 tablets. The dose of hormones is the same in both package types and they are equally effective. If you are supplied with a 2 tablet pack, the 2 tablets should be taken at the same time.

Who can take the ECP?
The ECP can safely be taken by women of any age, including teenagers, regardless of other health conditions.

What about other medications?
Some medications, including certain anti-epileptic medications, can reduce the effectiveness of the ECP and you may need an increased dose. Check with your doctor or the pharmacist if you are using other medications.

Is it safe to take the ECP when breastfeeding?
Yes, it’s safe to use the ECP when you are breastfeeding. It will not decrease your milk supply. A tiny amount of progestogen may come through the milk, but there is no evidence that this is harmful to your baby in any way.

What are the risks or possible side effects of the ECP?
The ECP is very safe to use with no health risks or serious side effects. Some women may experience either a delay or early arrival of the next period. Uncommon side effects include headache, dizziness, nausea and very rarely vomiting. If vomiting occurs within 2 hours of taking the ECP a repeat dose should be taken.

What happens after using the ECP?
Most women have a menstrual period within 7 days of the expected time frame. If your next expected period after taking the ECP is late or in any way unusual, it is very important to have a pregnancy test.

Do I need a pregnancy test?
It may be necessary to check for pregnancy 3-4 weeks after taking the ECP even if you have had bleeding that seems to be your period. It is essential that you do have a pregnancy test if:

  • your period is more than 7 days late or
  • your next period is lighter, heavier or in any way different from usual including unusual pain or
  • you have started or resumed hormonal contraception pills straight after taking the ECP or
  • advised by your doctor or pharmacist to have a pregnancy test or
  • you had a copper IUD inserted as EC

If the ECP doesn’t work and you find out that you are pregnant, having taken the ECP is not harmful to the pregnancy.

Does EC cause an abortion?
No, EC methods do not cause an abortion. They prevent pregnancy and don’t cause disruption to an established pregnancy.

Could taking the ECP affect my fertility?
No, taking the ECP does not have any impact on your future health or fertility.

What if I’m taking the ECP because of missed pills?
If taking “The Pill” (combined oral contraceptive pill) just keep taking your pills as usual. You will need to use condoms until you have taken 7 more hormonal contraceptive pills in a row.

What if I need to use it again?
ECP does not provide any ongoing contraception after it is taken. It can be taken more than once in the same menstrual cycle if again at risk of pregnancy.

What about using a copper IUD for EC?
A copper IUD needs to be inserted by a practitioner who is trained in this procedure. This can make it more difficult to obtain than the ECP. Contact your GP or your State or Territory family planning organisation to find out more about having a copper IUD inserted as EC.

Do I need a check for STIs?
The ECP does not protect you against sexually transmitted infections (STIs). If you have had sex with a new partner, have more than one partner or your partner has other partners, you may be at risk of STIs even if you have no symptoms. See your GP, a sexual health clinic or your State/Territory family planning organisation for testing. The consistent use of condoms is the only form of contraception that will also reduce the risk of STIs.

Unwanted sex
If you have been sexually assaulted or feel you were pressured into having sex at any time and want to talk to someone about this, please contact your State/Territory sexual assault service or your health care practitioner.

And remember... what about next time?
The ECP is not recommended as a regular contraceptive method. Using a reliable form of contraception is the best ongoing protection against unintended pregnancy. This can be a good time to update your knowledge and discuss your contraception needs with your health care practitioner.

Download this information from the SHFPA National fact sheet on Emergency Contraception here

View and download the SHFPACT fact sheet on Emergency Contraception here

 

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