Sex and Relationships: The morning-after pill

Heather Little-White, PhD, Contributor

It is becoming more common for young girls and women to have unprotected sex and then pop an emergency-contraception pill known as the morning-after or day-after pill to reduce their risk of becoming pregnant. The likelihood of not conceiving rests with the emergency-contraception medication if taken according to instructions within five days after having unprotected intercourse. Emergency contraception is also useful if you were forced to have sex.

The morning-after pill was approved by the Food and Drug Administration (FDA) in 1999 as a prescription drug for emergency contraception. In 2009, after lobbying from the manufacturer, the FDA approved the Plan-B pill for over-the ‹counter purchase by women 17 years and older. If a teenager under 17 needs the drug, then it would have to be prescribed by a doctor.

Plan B

The powerful pill is manufactured as two pills containing the synthetic hormone levonorgestrel. In the original version of Plan B, the first pill should be taken with food as soon as possible after intercourse and the other taken 12 hours later. Later, a single-pill version was developed and is taken as one single dose. The emergency contraception works by preventing ovulation and inhibiting movement of the sperm. Plan B can also prevent a fertilised egg from attaching to the womb as the lining of the uterus is altered by the pill which is laden with hormones which disrupts conception. The pill will only disrupt pregnancy if the fertilised egg is not already attached to the womb.

When to use

When should emergency contraception be used? Naturally, it should be used when a woman engages in unprotected vaginal intercourse. Other situations are:

When a condom burst or slips off during intercourse.

When a diaphragm slipped off during intercourse.

After sexual assault or rape.

Engaging in unprotected sexual intercourse even when two or more birth-control pills are missed during the first three weeks of a menstrual cycle.

Engaging in unprotected sex when women are two or more days late starting a new pack of birth-control pills or inserting the vaginal ring or using the patch.

When unprotected sex takes place more than 13 weeks since the last Depo-Provera shot.

Miscalculating 'safe' days and having sex on a day that a woman may have been fertile.

Forgetting to use normal birth-control method (for examples, she misses a pill(s) or did not insert her diaphragm or did not apply the birth-control patch).

Not pulling out on time - not a reliable method.

It is the success rate of the pill which boosts its popularity. The Plan-B pill is 95 per cent effective in reducing the risk of pregnancy if it is taken with 24 hours after engaging in unprotected sex. The longer a woman takes to take the Pill after unprotected sex, the greater her risk of becoming pregnant. It is believed that the emergency pill may provide protection up to five days after unprotected sex.

Side effects

As a medication, the morning-after pill is not without side effects. It may cause cramps in the abdomen, dizziness, tiredness and tenderness of the breasts. These symptoms should disappear within a few days after taking the Pill. It is also likely that a woman who has taken the Pill may experience changes in her menstrual cycle and the menstrual flow may be less or she may have spotting afterwards.

If you can take regular birth-control pills, you should be able to take emergency contraceptive pills. However, if you are pregnant, have breast cancer, or have had blood clots, you should not use emergency contraceptive pills. In these instances, you should talk with your doctor about whether emergency contraception is right for you (familydoctor.org).

While emergency contraception reduces your risk of becoming pregnant, it is not as effective as birth control used before or during sex. Classic examples are the Pill and condoms. So if you are sexually active or planning to be, you should not use emergency contraceptives to prevent pregnancy. Besides, having sex without leaves you more likely to contract sexually transmitted infections, like HIV.

Birth-control myths

Why would a woman resort to taking the emergency pill instead of using birth control? She may be harbouring several myths about birth control robbing her of the decision to use birth control. She may believe that she cannot get pregnant if she engages in unprotected sex while menstruating. This is not true as she could get pregnant if she has unprotected sex while menstruating.

A woman may also believe that if she douches right after having unprotected sex, she cannot get pregnant. While the douche will wash out the vagina, it will disturb the good and bad bacteria within the vagina, but not wash out the sperm and sexually transmitted infections.

That it is impossible to get pregnant the first time having vaginal sexual intercourse: This is untrue as pregnancy takes place with one and the first sexual liaison. Women may also believe that if the man pulls out before ejaculation known as the withdrawal, she will not get pregnant.

Almost every woman who needs emergency contraception can safely use it. However, it should not be relied on as an easy method for preventing pregnancy.