GUIDE FOR PATIENTS

GUIDE FOR PATIENTS

Emergency contraception: An option you should know about

Did you know there is a way to prevent pregnancy, even if you've hadintercourse without using something to prevent pregnancy? Well, there is.It's called emergency contraception. This guide will explain how emergencycontraception works and tell you how to get it. You're welcome to sharethis information with your friends.

What is emergency contraception?

Emergency contraception is a way of preventing pregnancy after unprotectedsex, before pregnancy begins. It's usually done by taking a higher-than-usualdose of certain birth control pills used for routine pregnancy prevention.The high dose must be taken within three days (72 hours) of unprotectedintercourse, but the sooner you take the pills, the better your chancesof avoiding pregnancy. If you are already pregnant from an earlier act ofunprotected intercourse, taking high-dose pills now won't stop the pregnancyor cause an abortion or miscarriage.

Why would I need it?

If you don't want to get pregnant, you might need emergency contraceptionin a number of situations. For example, suppose you had sex and...

• didn't use any protection
• the condom broke or slipped off
• you forgot to take your birth control pills
• you were late starting your birth control pills
• you were late for your Depo-Provera shot
• it was the first time and you weren't prepared
• you didn't know your partner well and were afraid to ask him to use a condom
• you were raped or forced to have sex.

How does it work?

Emergency contraceptive pills are just like the pills used for routinebirth control. These pills contain two hormones called progestin and estrogen.When you use them for ongoing birth control, you take one pill a day andthe small amount of hormones in the pill provides continuous protectionagainst pregnancy. When you use the pills for emergency contraception, youtake two large doses (two or more pills at a time, 12 hours apart).

The large dose of hormones can prevent pregnancy in several ways. Ifit's the right time in your menstrual cycle, the pills can block the ovaryfrom releasing an egg (ovulation); if no egg is released, no pregnancy canoccur. If you've already ovulated, the hormones can prevent sperm from fertilizingan egg so that the egg cannot develop into a pregnancy. If the egg is alreadyfertilized but not yet attached to the lining of the womb, the hormonescan prevent the fertilized egg from attaching and starting to grow (implantation).If implantation has already taken place, however, emergency contraceptionwon't work; it does not cause an abortion.

How do you use the pills for emergency contraception?

Emergency contraceptive pills should be taken as soon as possible afterunprotected sex. They must be taken no later than three days (72 hours)after unprotected sex, or they may not work. Take the first dose as soonyou can and the second dose
12 hours later. The number of pills you need to swallow each time dependson which brand of birth control pills you use. You must follow your health-careprovider's instructions about how many pills to take and use only thosebrands that are recommended for emergency contraception. Some brands can'tbe used this way, so follow the instructions you're given precisely.

How effective is emergency contraception?

It's less effective than continuous or pre-planned birth control, butit's the only method that works after unprotected intercourse. Emergencycontraception pills reduce the chances of getting pregnant by 75%.

Can anyone use emergency contraception?

Most young women can use emergency contraception. Tell your health-careprovider if you have ever had unexplained vaginal bleeding, a stroke, bloodclots in your legs or lungs, or any medical problems like liver diseaseor kidney disease. Your health-care provider may do a pregnancy test tomake sure you are not already pregnant; if the test is positive, you willnot be given emergency contraception.

What about side effects?

About a third of women who use emergency contraception may have nauseaand about a fifth have vomiting for a day or two. You can ask for medicationto prevent nausea and you may also
be given an extra dose of emergency contraception pills to take in caseyou throw up a dose. Tell your health-care provider if you have had nauseain the past when taking oral contraceptives or emergency contraception.Your next period may be early or a little later than usual. Other side effectsmay include headaches, breast tenderness, dizziness, mood changes, blurredvision, tiredness, or cramps. All side effects go away within a day or two.Emergency contraception will not make it more difficult for you to get pregnantin the future.

Are there any serious risks?

Studies show that emergency contraception is safe. Serious problems arevery rare, but may include severe headaches, chest pain, severe stomachpain, swelling and pain in the legs, problems with breathing, or loss ofvision. If you experience any of these problems, call your health-care provider.

Can I use emergency contraception as my main method of birth control?

NO! First of all, emergency contraception doesn't always work; standardbirth control methods are more effective in preventing pregnancy. Second,birth control pills do not protect you from sexually transmitted diseases,including infection with the virus that causes AIDS. Only condoms can protectagainst those diseases. Discuss all your birth control options with yourhealth-care provider and choose a method that makes the best sense for you.

Do I need to see my health-care provider after I use emergency contraception?

Yes. You should get a checkup two weeks after you use emergency contraception,to make sure you are not pregnant and that you do not have a sexually transmitteddisease.

How can I get emergency contraception?

If you have a regular pediatrician or other health-care provider, calland say "This is __________________, and I need to get emergency contraceptionas soon as possible." Some doctors require you to come in for an appointment,while others will prescribe the medication over the telephone, so have thename and number of your pharmacy handy when you call. If you don't knowwho to call, you can get the name of a provider near you from the emergencycontraception hotline; call 800-584-9911. Though it's always best to discussyour health concerns with your family, you can get emergency contraceptionconfidentially without your parent's consent--even if you're under 18.

--Melanie A. Gold, DO

--Roberta N. Miller, M Phil