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10 February, 2010

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Contraception - emergency contraception

Sometimes emergency contraception is needed to prevent pregnancy after sex. This may be necessary if you have sex without any contraception, you miss taking the oral contraceptive pill or a condom breaks. It may also be necessary in the case of rape.

Emergency contraception, previously known as the ‘morning after pill’, must be started within 120 hours of having unprotected sex.

Emergency contraception prevents unwanted pregnancies
Emergency contraception is about 85 per cent effective. It works by:

Delaying or preventing ovulation
Preventing a fertilised egg from sticking to the wall of the uterus (womb).

As the name implies, this form of contraception is meant to be used only in emergencies – it is not an ongoing or long-term method of contraception. It is not as effective as using condoms.

Different types of ‘morning after pills’
There are different types of emergency pills available. All types of emergency contraception are more effective the sooner they are started after unprotected sex. If you have unprotected sex and you want to reduce your risk of pregnancy, you need to take the first dose of emergency pills as soon as you can, but definitely within 120 hours (five days).

The ‘progesterone only’ method is the most commonly used in Australia. This involves a dose of emergency contraception pills – either one full dose or two half doses depending on the product (Postinor-1, Levonelle-2 or Norlevo) – containing a dose of a female hormone. This is similar to taking a large quantity of the mini pill. A doctor can prescribe these pills, but they can also be purchased over the counter without a prescription at many pharmacies throughout Australia.

If using the single pill dose you will be advised to take it straight away. If using the two half dose pills, the pharmacist may advise you to take both pills at once or to take one immediately and one 12 hours later. Either way is fine. ‘Progesterone only’ emergency contraception is considered safe to use when breastfeeding and it is rare for a health issue to be a reason not to take it. However, some medications can make it less effective, so check with the pharmacist.

You must keep using other contraception, such as condoms, for the rest of your cycle until your next period – otherwise you may still become pregnant.

If you are taking the pill
Emergency contraception may be needed if you miss any of the first seven active pills of a cycle and have unprotected sex (those pills that are taken straight after you finish the seven sugar pills). After taking emergency contraception keep taking your pills as normal and use condoms until you’ve had seven active pills in a row.

Your next period
After the emergency pill, most women have their next period roughly on time. About 20 per cent will have an early period and ten per cent a late one. The combined or mini pill can be started immediately after emergency contraception.

The next step
After taking emergency contraception, you may need to:

Get a pregnancy test – if your next period is more than seven days late, is in any way unusual or is associated with more pain than usual.
Be screened for an STI – if you think you could be at risk. Some sexually transmissible infections (STIs) do not give women or men symptoms, but can cause long-term complications such as infertility.
Think about future contraception – ask your doctor or family planning practitioner for information about your options to help you decide what you would like to use to prevent an unplanned pregnancy.

Protect against STIs
It is important to practise safe sex. The best way to reduce the risk of sexually transmissible infections (STIs) is to use barrier protection such as male and female condoms and dams (a thin piece of latex placed over the anal or vulval area during oral sex). Condoms can be used for oral, vaginal and anal sex (in conjunction with other contraceptive methods where required) to help prevent the spread of infections.

Where to get help

Your doctor
Family Planning Victoria Tel. (03) 9257 0100 or 1800 013 952
The Action Centre (for young people under 25) Tel. (03) 9654 4766 or 1800 013 952
Women’s Health Information Centre, Tel. (03) 9344 2007 or 1800 442 007
Melbourne Sexual Health Centre Tel. (03) 9341 6200 or 1800 032 017 or TTY (for the hearing impaired) (03) 9347 8619
Community health centre
Pharmacist
Public hospital – if you can’t get to any of the above services within 120 hours of unprotected sex, try the emergency department of a public hospital.

Things to remember

Emergency contraception prevents pregnancy after sex and must be started within 120 hours of unprotected sex.
Emergency contraception is 85 per cent effective.
Condoms and dams provide the best available protection against sexually transmissible infections (STIs).

You might also be interested in:
Contraception - choices explained.
Contraception - condoms for men.
Contraception - condoms for women.
Contraception - diaphragms and cervical caps.
Contraception - implants and injections.
Contraception - injections for men.
Contraception - intrauterine devices.
Contraception - the pill.
Sex - are you ready.
Sex education - talking to teenagers.
Sexually transmissible infections - overview.
Sexually transmissible infections - signs and symptoms.
Teenage pregnancy.

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