Emergency contraception (EC) is a contraceptive method that can be used after an unprotected intercourse, failed contraception or sexual assault to prevent an unwanted pregnancy. The methods includes taking pils and insertion of intrauterine device (IUD). However in this article, only the pill will be discussed.
In 1970s, a method where the women would be given 0.1 mg ethinylestradiol and 0.5 mg levonorgestrel (LNG), within 72 hours of the intercourse and repeated after 12 hours. A few years later, treatment with levonorgestrel (LNG) only was introduced. This new regiment was shown to be associated with less side-effects and higher efficacy compared to the older treatment.
The latest hormonal emergency contraceptive method is ulipristal acetate(UPA). It has been developed and approved for emergency contraception use for up to 5 days after sexual interaction( the lifespan of sperm in reproductive tract). UPA is frequently more expensive and received by prescription-only but demonstrates greater efficacy.
To date, it is unknown whether UPA is excreted in human breast milk. However, since due to its chemical structure, it is at least theoretically possible. Therefore it is advised for breastfeeding women who require EC and who take UPA not to breastfeed for 36 hours following UPA intake. Your physician would most probably prescribe LNG if you are breastfeeding.
Emergency contraceptives are of use only after unprotected sex. EC should not be confused with treatment for medical abortion. As the term 'emergency' indicates, it is not for regular ongoing use although the use may be repeated. Use of oral contraceptives and/or barrier method are recommended for long-term protection from unwanted pregnancy.
Following emergency contraception use, several additional measures should be taken to ensure no pregnancy will occur. It is advisable to start an oral contraceptive regiment immediately following use of Emergency contraceptive pills. Barrier methods should also be used for 1-2 weeks following use of the emergency contraception.
Reference
Best Practice & Research Clinical Endocrinology & Metabolism
Volume 27, Issue 1, February 2013, Pages 91–101
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