Emergency Contraception (EC) is a method which is used to prevent pregnancy after few hours or days of intercourse. It is called emergency contraception because the partners may have had some accidents while performing intercourse. EC offers people a last chance to prevent an unwanted pregnancy when other contraceptive methods fail, after unprotected sex or in the case of a sexual assault. Most types of EC are less effective than other forms of modern birth control, and they don’t protect against sexually transmitted infections but EC can make a woman much less likely to get pregnant.
Key Points to Know:
Copper IUDs are the most effective form of emergency contraception.
Emergency contraceptive pills are most effective the sooner you take them, but can still have some effects for up to 4-5 days after unprotected intercourse.
Emergency contraceptive pills might be far less effective, or ineffective, during 1-2 days of each cycle, right around the time of ovulation.
Proper Time for using EC:
You can consider using EC after unprotected intercourse when there is a possibility you could be fertile. This includes 5–7 days before ovulation occurs, until 1–2 days afterwards your fertile window. Ovulation usually happens in the middle of the menstrual cycle, but this can be different for everybody, especially if your cycles are not regular.
Options for EC:
There are two major options for emergency contraception: Emergency contraceptive pills (ECPs) and the Copper IUD or Intra Uterine Device.
Emergency Contraceptive Pills:
Emergency contraceptive pills are better known as ‘Morning after Pills’ although we may name them ‘As Soon As Possible’ pills. There are two main types of ECPs available in the Bangladeshi market, Levonorgestrel and Ella.
The most common type of ECP contains levonorgestrel, and is marketed under different brand names and available without a prescription. Levonorgestrel ECPs are taken in a single dose as soon as possible after unprotected intercourse. While the packages of these pills may state that they should be taken within 72 hours, their effectiveness may last for at least 4 days (96 hours).
The other ECP, called Ella, contains anti-progestin called ulipristal acetate. Ella is only available with a prescription, and is taken in either a single or split dose. Ella is considered to be the most effective type of ECP and may be effective if taken until at least 5 days (120 hours) after unprotected intercourse.
Emergency contraceptive pills primarily work by blocking or delaying ovulation. They change the body’s hormones to prevent the release of an egg from the ovary. When ovulation doesn’t happen, sperm cannot come in contact with an egg. So pregnancy doesn’t occur.
The Copper Intrauterine Device (IUD):
Copper IUDs are the most effective form of emergency contraception. They are small devices, inserted into the uterus to prevent pregnancy. They’re a long-lasting contraceptive, and can stay in the body for up to 10 years.
Copper IUDs can be used as emergency contraception if they are inserted into the uterus up to 5 days after ovulation. Since the exact timing of ovulation is difficult to know, most sources recommend inserting the IUD up to 5 days after unprotected intercourse to ensure it will be effective and safe. Copper IUDs are inserted by medical professionals in a clinic.
A copper IUD will work by preventing sperm from fertilizing an egg, or, if an egg is already fertilized at the time a copper IUD is inserted, the IUD will prevent the fertilized egg from implanting in the uterus. Copper IUDs are nearly 100% effective as emergency contraception, making them the most effective option.
Data from 1993-2007 show that there has been a gradual decline in trends of unintended pregnancy in Bangladesh from 33% to 29%; among the 29%, 15% were mistimed (wanted later) while 14% were unwanted. In 2011, 61% of married women were current users of a contraceptive method, either modern or traditional, which is a small increase from the data collected in the Bangladesh Demographic and Health Survey (BDHS) 2007. Despite this rise in contraceptive prevalence rate (CPR), the unmet need for family planning is estimated to be 14% among women of reproductive age in the country. So access to contraception is an essential component of reproductive health services, which helps to lower the levels of unmet need for family planning and, in turn, the numbers of unintended pregnancy. Knowing the options and informing your choices can help you in making emergency contraception as effective as possible.
Tasmi Akter is a professional pharmacist from Bangladesh; she is serving as Analytical Development Executive at Eskayef Bangladesh Limited, a multinational pharmaceutical company. She can be reached at firstname.lastname@example.org
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