Emergency contraception:
Everything you ever wanted to know!

What's Inside?

Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after unprotected or inadequately protected sexual intercourse.

Who is likely to use it?

  • Unprotected intercourse or failure to use any kind of contraception.
  • Contraceptive failure/misuse – tear or bursting of a condom, failure to take a pill.
  • Sex was forced without use of a contraceptive.

Examples include

  • A condom breaks, slips off, or is not used the whole time a couple is having sex.
  • A woman who normally takes birth control pills containing both estrogen and progestin forgets to take her birth control pills two or more days in a row.
  • A woman who normally takes birth control pills containing just progestin (called the “minipill”) takes her pill more than three hours late.
  • A woman who normally uses injections of depot-medroxyprogesterone acetate (also called Depo-Provera; Depo-Provera Contraceptive; depo-subQ Provera 104; and Provera) is more than two weeks late for her injection (some providers recommend emergency contraception only if the woman is more than four weeks late for her injection).
  • A diaphragm or cervical cap moves, breaks, tears, or is removed too soon.
  • A birth control vaginal ring comes out, is removed too early, or is inserted too late.
  • A man fails to “pull out” or withdraw in time and comes or ejaculates either inside the woman or on her genitals.
  • A sperm-killing tablet or film fails to melt before sexual intercourse.
  • A woman who uses the rhythm method makes a mistake figuring out the “safe time” in her cycle, or she has intercourse during the days she is likely to conceive.
  • An intrauterine device (IUD) accidentally comes out.

Emergency contraceptive pills are less effective for overweight women.

Studies indicate that emergency contraceptive pills, including both levonorgestrel and ulipristal acetate pills, may not work as well for overweight or obese women as they do in normal weight women. For this reason, women who weigh 165 pounds (75 kilograms) or more may want to consider a copper IUD instead of emergency contraceptive pills if they need emergency contraception.

The copper IUD works well in woman of any weight. If an overweight woman chooses to use oral emergency contraception, ulipristal seems to be more effective than levonorgestrel.

Have it ready- Studies have shown that emergency contraceptives are most effective when taken within the first 24 hours following unprotected intercourse.

Are they safe?

Yes excluding all major contraindications, these drugs are safe for most people, including smokers, women over 35 years of age, hypertensives and diabetics.

Does taking a pill mean I am safe for the entire cycle?

No it does not. The oral contraceptives act by speeding up or delaying ovulation and causing a desynchronisation between the uterine lining and egg. They do not guarantee that an egg will not be fertilized in an unprotected intercourse in the same cycle. It is advisable to continue using your usual method of contraception for the remainder of your cycle.

If you have forgotten to take your birth control pills more than twice, you should ideally be using barrier contraception in the form of male or female condoms or diaphragms till your next period.

If you have taken the tablets Esmya or Elata, you should wait for five days before resuming your original method of birth control.

When will I get my next period?

Ideally, you should get your period in the same week as your predicted date. Your periods may come before or after your expected date. The kind of flow also may change from the usual.

At what point should I reach out to a doctor?

  • If you don’t get periods
    If you don’t get your period within a week of the expected date, take a pregnancy test and get a doctor’s appointment.

  • If you experience heavy bleeding and any of the following symptoms
  1. Excessive bleeding, which means you have to change your sanitary products every hour or two.
  2. You are passing blood clots larger than 2.5 cm (about the size of a 10p coin).
  3. You are bleeding through to your clothes or bedding.
  4. You need to use 2 types of sanitary product together (for example, tampons and pads).
  • If you experience any other disturbing symptoms
    Symptoms such as severe nausea and vomiting, dizziness or loss of consciousness.
  • If you suspect you may have developed an associated STI/UTI
    Symptoms such as increased vaginal discharge, burning, foul-smelling vaginal discharge, burning during urination or abdominal pain may be suggestive of infections.

How many pills can I take?

It is not absolutely forbidden to take more than one pill in any cycle but we suggest you don’t take it for the following reasons:

  • These pills contain high levels of hormones and it may lead to heavy bleeding and unpleasant side effects.
  • It is less effective as compared to a regular method of birth control.( only applicable to Levonorgestrel and Ulipristal)
  • It is costlier than regular methods of birth control.