EMERGENCY CONTRACEPTION

Emergency Contraceptive Pills (ECP) are most commonly referred to as the “morning-after pill.” There are currently three types of emergency contraceptive pills available in Canada: the levonorgestrel progestin-only method (Plan B®), the ulipristal acetate method (Ella®), and a method that involves using birth control pills that both estrogen and progestin in a special dosing pattern (Yuzpe).

 

The Yuzpe method does not work as well as the dedicated ECP products ( Plan B® or Ella®); this method involves taking combined oral contraceptive pills that contain ethinyl estradiol and progestin; they must be taken in a dosing pattern that is very different from use as an oral contraceptive. Use of the Yuzpe method should be reserved for situations where people can obtain combined oral contraceptive pills but cannot obtain a dedicated ECP (Plan B® or Ella®) product within two to three days. Nausea and vomiting is more common with the Yuzpe method; it is also not appropriate for people who cannot safely take estrogen.

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How Does ECP Prevent Pregnancy?

• It can prevent the egg from leaving the ovary

• It can prevent the sperm from meeting the egg

• It can prevent the fertilized egg from attaching to the uterus

 

ECP must be used as soon as possible within 72 hours of unprotected sexual intercourse or known or suspected contraceptive failure. Treatment for emergency contraception should begin as soon as possible; however, treatment is still moderately effective if used within 5 days and should be made available to patients who may become pregnant up to 5 days after unprotected or inadequately protected intercourse. It may be used at any time during menstrual cycle and may be used more than once within the same cycle (ACOG 2015).

 

It does not cause disruption to the embryo once fertilization and implantation has occurred. In other words, ECP prevents pregnancy, but does not cause a miscarriage or abortion. 

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Advantages of Using ECP

• ECP is the only oral method of contraception used to prevent pregnancy after unprotected sex.

• It works: Plan B® is 97.4 - 98.3% effective in preventing pregnancy when used within 72 - 120 hours of a single episode of unprotected intercourse; Ella® is 98.2 - 98.8% effective in preventing pregnancy when used within 72 - 120 hours of a single episode of unprotected intercourse

• It is available without a prescription from pharmacies.
   

Disadvantages of Using ECP

• ECP does not work if you are already pregnant

• It must to be used within a limited time frame to be effective

• It cannot be used as a regular method of birth control

• Most people tolerate ECP; however it can cause minor side effects in some users such as fatigue, breast tenderness, headache, and abdominal pain. People rarely feel nauseated after taking Plan B® or Ella®. It may cause changes in the next menstrual period.

• ECP works less well in overweight (BMI 25 to 29.9 kg/m2) and obese (BMI ≥30 kg/m2) individuals due to decreased concentrations of the medication in blood.

• It does not offer protection against STIs