All your Emergency Contraception questions answered

By Siddhi Jain
New Delhi, Feb 14 (IANSlife) Sexual and reproductive health was the top consulted specialty online in 2020, with one in every four consultations from women during the year coming for sexual and reproductive health, according to insights from Practo, which says it registered 4000+ queries related to SRH every hour in 2020 – an increase from 1000+ queries in 2019.

These findings also indicate an increase in queries for rare disorders like sexsomnia and anorgasmia from young Indians. According to experts, health concerns like sexsomnia and anorgasmia are triggered by the rise in stress, sleep deprivation, and other lifestyle changes that happened during the lockdown.

Pradeepkumar Sandipan Jadhavar, Gynecologist/Obstetrician, who consults on Practo, answers some FAQs on sexual and reproductive health:

Q: What is emergency contraception?

A: Emergency contraception — also called post coital contraception — is a form of birth control that may be used by women who have had unprotected sex or used a birth control method that failed. There are 2 types of emergency contraception:

* Pill form Popularly known as plan B or morning after pill (available with trade name I pill, Unwanted 72 , smart 72), pills containing Levonorgestrel are to be taken within 72 hrs of an unprotected sex;

* IUD : Multiload or intrauterine contraception devices are more effective than pills in preventing a pregnancy in these situations. They can be used up to 120 hrs or 5 days.

Q: What are methods of emergency contraception ?

A: The methods of emergency contraception are: ECPs containing LNG; combined oral contraceptive pills; copper-bearing intrauterine devices.

Q: Can it be used as a regular method of birth control ?

A: The treatment generally is reserved for specific situations and is not a regular method of birth control.

Q: In what situations can emergency contraception be used?

A: Emergency contraception can be used in a number of situations following sexual intercourse: When no contraceptive has been used; sexual assault when the woman was not protected by an effective contraceptive method; and when there is concern of possible contraceptive failure, from improper or incorrect use.

Q: Can it be used for abortion?

A: Emergency oral contraception is used to prevent a pregnancy, not end one.

Q: How does it work ?

A: Emergency contraceptive pills prevent pregnancy by preventing or delaying ovulation and they do not induce an abortion. The copper-bearing IUD prevents fertilisation by causing a chemical change in sperm and egg before they meet. Emergency contraception cannot interrupt an established pregnancy or harm a developing embryo.

Q: Who can use emergency contraception ?

A: Any woman or girl of reproductive age may need emergency contraception to avoid an unwanted pregnancy. There are no absolute medical contraindications to the use of emergency contraception. There are no age limits for the use of emergency contraception. Eligibility criteria for general use of a copper IUD also apply for use of a copper IUD for emergency purposes.

Q: What is the time frame to use emergency contraception ?

A: * Pill form — within 72 hours
* IUD — within 120 hours

Q: What efficacy of emergency contraception ?

A: Studies have shown that ECPs with LNG had a pregnancy rate of 1.2 per cent to 2.1 per cent. Ideally ECPs should be taken as early as possible after unprotected intercourse. When inserted within 120 hours of unprotected intercourse, a copper-bearing IUD is more than 99 per cent effective in preventing pregnancy.

Q: What safety of emergency contraception ?

A: Side effects from the use of ECPs are similar to those of oral contraceptive pills, such as nausea and vomiting, slight irregular vaginal bleeding, and fatigue. Side effects are not common, they are mild, and will normally resolve without further medications. A copper-bearing IUD is a safe form of emergency contraception.

Q: What if vomiting occurs after consuming ECP?

A: If vomiting occurs within 2 hours of taking a dose, the dose should be repeated.

Q: Can ECP harm fertility ?

A: Drugs used for emergency contraception do not harm future fertility. There is no delay in the return to fertility after taking ECPs.

Q; Is ECP effective in obese women?

A: Emergency contraceptive pills were found to be less effective in obese women (whose body mass index is more than 30 kg/m2), but there are no safety concerns. Obese women should not be denied access to emergency contraception when they need it.

Q: Can it protect against STI?

A: The ECP does not protect against STIs.

Q: Can it be protected again in the same cycle?

A: It won’t protect against pregnancy if you have unprotected sex again in the same menstrual cycle. You should use condoms until you’re protected fully by another regular method of contraception.

Q: What if ECP is used in a patient already pregnant?

A: Levonorgestrel will not affect an implanted pregnancy.

(Siddhi Jain can be contacted at siddhi.j@ians.in)

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