What are Emergency Contraceptive Pills?
Emergency contraception is a method of birth control that can be used by a woman who has had unprotected sex or used birth control that failed. This can prevent over 90% of pregnancies. Emergency contraceptives in Sri Lanka can be bought over-the-counter in local pharmacies. It is advised to be taken within 72 hours and is more effective when taken sooner than later after intercourse.
These pills, however, are also used in cases where one is sexually assaulted, possible contraceptive failure, incorrect use of contraceptives, had a condom break during intercourse or missed two or more birth control pills during the monthly cycle. Emergency contraceptive pills only prevent pregnancy but do not end one. It does not protect against STDs (sexually transmitted disease), neither does it induce abortion.
Emergency Contraceptives in Sri Lanka
There are 2 well-known and highly available brands of emergency contraceptives in Sri Lanka.
This brand has two variations of the pill. One with 2 doses and another with a single dose and aptly named as Postinor-2 and Postinor-1 respectively:
According to the Family Planning Association Sri Lanka:
1. Postinor One
Postinor One (morning-after pill or day-after pill) is a single dose oral emergency contraceptive pill. This also should be taken within 72 hours of unprotected sexual intercourse. This regime allows you to take only 1 pill which is more hassle-free than taking 2 pills. If taken early the effectiveness is definitely more. It does not cause an abortion and should not be used as a regular contraceptive method.
2. Postinor 2
An emergency contraceptive pill (morning-after pill or day-after pill ) to be taken within 72 hours of unprotected sexual intercourse – failure or incorrect use of a regular contraceptive, after rape or incest. You can either take both the tablets together or take one tablet and take the other one 12 hours later. Efficacy depends on the time of consumption. If taken early the effectiveness is definitely more. It does not cause an abortion and should not be used as a regular contraceptive method.
You might wonder why Postinor 2 needs to be taken in 2 doses if you can work with the single dose. The requirement is to consume the full dose as soon as possible for high effectiveness. So the full dose can be taken at the same time or as 2 separate doses 12 hours apart. The result is the same. But, it is recommended to take the pills in 2 separate doses.
Emcon contraceptive in Sri Lanka comes only in 1 type with 2 separate doses.
According to Population Services Lanka:
EMCON® is an emergency contraceptive for women. EMCON® should be used within 72 hours of unprotected intercourse. It should not be taken as a regular birth control pill. This medicine is also known as Post Coital Pill and Morning After Pill. The active substance in this medicine is levonorgestrel. Each EMCON® tablet contains 0.75mg Levonorgestrel. Levonorgestrel belongs to a group of medicines called progestogen. Each pack of EMCON® contains 2 round, white tablets.
Now that we have introduced you to the two major emergency contraceptive pills in Sri Lanka, it is time we explained to you how it works and other relevant information you will need to be aware of.
How do They Work?
No single working of action has been confirmed for emergency contraception. The mode of action depends on the day of the menstrual cycle on which intercourse occurs, the time during the cycle when the emergency contraceptive is taken, and the type of emergency contraceptive.
ECP (Emergency contraceptive pills) work by temporarily blocking or delaying the release of the egg from the ovaries, hence stopping fertilization. Another way it works is also by keeping a fertilized egg from being embedded in the uterus. These pills prevent the sperm from fertilizing the egg but do not work if the egg is fertilized. Emergency contraception cannot interrupt an established pregnancy or harm a developing embryo.
Side Effects of ECP
- Vomiting or aversion to food
- Tenderness of breasts
- Heavy menstrual bleeding or in-between periods
- Pain or cramps in the lower abdomen
If vomiting occurs within 2 hours of taking a dose, the dose should be repeated.
Steps Required Before Taking ECP?
No medical examination or pregnancy tests are required for the authorization of emergency contraceptive pills. Therefore, emergency contraception should not be held up in order to test for pregnancy. Administration of these emergency contraceptives should not be rejected as the intercourse could have occurred on a non-fertile day of the menstruation cycle.
When to Take ECP?
Treatment should begin as soon as possible after unsafe sexual intercourse to maximize effectiveness. Ulipristal acetate’s efficacy continues for 5 days after copulation. Levonorgestrel after unprotected sex can be used up to 72 hours.
What Clinical Follow-up is Needed After Use of Emergency Contraception?
A scheduled follow-up is not required after the use of emergency contraceptives in Sri Lanka. Although, a medical evaluation is indicated for women:
- Who have used ECP if her menstrual cycle has been delayed by a week or more after the expected time
- If frequent irregular bleeding or lower abdominal pain develops. These symptoms could indicate a spontaneous pregnancy loss or an ectopic pregnancy.
Myths about ECP
ECP is not effective if several acts of intercourse have occurred in a row, at the same time?
NO. ECP is equally effective after one or several acts of intercourse in a row provided that all the acts have taken place within 72 hours preceding the intake of the drug.
ECP will act as an efficient contraceptive method until the next menstrual period?
NO. So it is strongly recommended to use a barrier method at each intercourse until the next period and start using a regular suitable contraceptive method from then onwards.
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