Saturday, January 8, 2011

Emergency Contraception

also referred to as the “morning after pill”
[Portions of his article are from the May, 2010 ACOG Practice Bulletin (American College of Ob/Gyn, Practice Bulletin number 112, May 2010)]
A single act of unprotected intercourse -- if it occurs around the time of ovulation -- is associated with about a 1 in 6 chance of the woman becoming pregnant. If pregnancy is not desired, then one option is the use of the morning-after pill, also referred to as emergency or post-coital contraception.
The two most common reasons to consider post-coital contraception involve condom failure (it broke, or was used incorrectly, during intercourse) or not using contraception at all (unprotected intercourse).
There are 2 FDA approved products that can be used for emergency post-coital contraception. One is the original Plan B, which is being phased out and replaced by the company with a newer version called Plan B One-Step.
Plan B One-Step is a single pill containing a high dosage of a progesterone-like hormone (called a progestin). Plan B One-Step can be taken up to 72 hours after the act of unprotected sex and is about 85% effective in preventing a pregnancy that would otherwise have occurred. One study showed effectiveness even when taken up to 120 hours after unprotected sex. It is thought to work by changing the uterine lining so that the fertilized egg will fail to implant or by delaying ovulation but experts disagree on the mechanism of action.
There are possible side effects, usually mild, that include: cramping, bloating, breast tenderness, spotting, headache and nausea. There is also the possibility of a continuing pregnancy, and the rare chance of an ectopic pregnancy. If you do not get your period about 2 weeks after taking Plan B One-Step, you should perform a home pregnancy test. If you remain pregnant, it is important to know that Plan B One-Step is not known to be a cause of birth defects.

If you are 17 or older, Plan B One-Step can be purchased without a prescription, but usually you have to request it at the pharmacy counter. Persons under age 17 are required to have a doctor’s prescription. The original Plan B is the same product except there are 2 pills. They are taken 12 hours apart and together contain the exact same dose of progestin as the single pill of Plan B One-Step.
The “morning after” Pill should not be used as a routine form of birth control due to the higher failure rate compared to other forms of birth control such as the birth control Pill, condoms and IUD’s. This approach also provides no protection from STD’s or HIV. For the rest of the cycle, you should use condoms to prevent the chance of becoming pregnant later in the same cycle.

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